Fetal atrial tachycardia diagnosed by magnetocardiography and direct fetal electrocardiography. A case report of treatment with propranolol hydrochloride.
At 26 weeks of gestation, fetal tachyarrhythmias (about 250 bpm) and ascites were detected by ultrasonography, and oral treatment with propranolol (30 mg/day) was commenced. Within 10 h, the fetal heart rate changed to approximately 85 bpm. The averaged fetal magnetocardiogram triggered by R peaks showed P wave and QRS complexes and an extra P wave. In addition, many extra nonconducted P-waves were detected in a fetal direct electrocardiogram. At 27 weeks of gestation, fetal tachycardia occurred again, and arrhythmia was diagnosed as the result of a blocked premature atrial contraction (PAC) with intermittent atrial tachycardia by fetal electrocardiogram. Administration of transplacental propranolol (90 mg/day) resolved the fetal tachyarrhythmias and ascites. Further studies are required to evaluate the efficacy and adverse effects of propranolol for fetal atrial tachycardia.
Ishii
Keisuke
K
Department of Perinatology, National Cardiovascular Center, Suita, Osaka, Japan.
Chiba
Yoshihide
Y
Sasaki
Yoshihito
Y
Kawamata
Kazuya
K
Miyashita
Susumu
S
D000328:Adult; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D008280:Magnetics; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D013617:Tachycardia, Supraventricular / Q000175:diagnosis* / Q000503:physiopathology