title: Flecainide as first-line treatment for fetal supraventricular tachycardia.
abstract: OBJECTIVE
  The aim of this study was to evaluate utilization, efficacy, and side effects of flecainide treatment as first-line agent in patients with fetal supraventricular tachycardia (SVT).
  
  
  METHODS
  This retrospective review was conducted on 23 consecutive fetal tachyarrhythmia cases that met inclusion criteria. If the treatment was necessary, then flecainide was used as first-line treatment in all cases.
  
  
  RESULTS
  Among the study group, there were 21 (91.3%) cases of SVT and 2 (8.6%) cases of Atrial Flutter (AF). Sixteen fetuses had persistent SVT and five fetuses had intermittent SVT. We treated 17 fetuses with flecainide monotherapy and 15 of them converted to sinus rhythm and remaining two fetuses were refractory to monotherapy. The median time to conversion to sinus rhythm was 3.8 ± 1.6 days. Only one fetus (20%) among the intermittent SVT cases required anti-arrhythmic treatment.
  
  
  CONCLUSIONS
  Our study has demonstrated that flecainide is an effective first-line treatment for fetal SVT with high success rate (88.2%), low side effect profile and relatively easy utilization. Based on the current study and recently published article results, flecainide can be recommended as the drug of first choice for treatment of fetal SVT cases.
authors.affiliation: a Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Unit , Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Ekiz
authors.affiliation: a Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Unit , Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey.
authors.forename: Basak
authors.initials: B
authors.lastname: Kaya
authors.affiliation: b Department of Pediatric Cardiology , Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey.
authors.forename: Helen
authors.initials: H
authors.lastname: Bornaun
authors.affiliation: a Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Unit , Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey.
authors.forename: Deniz Kanber
authors.initials: DK
authors.lastname: Acar
authors.affiliation: a Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Unit , Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey.
authors.forename: Muhittin Eftal
authors.initials: ME
authors.lastname: Avci
authors.affiliation: c Department of Obstetrics and Gynecology , Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey.
authors.forename: Aysegul
authors.initials: A
authors.lastname: Bestel
authors.affiliation: a Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Unit , Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Yildirim
mesh_terms: D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D004452:Echocardiography; D005260:Female; D005315:Fetal Diseases / Q000188:drug therapy*; D005318:Fetal Heart / Q000000981:diagnostic imaging; D005424:Flecainide / Q000627:therapeutic use*; D005865:Gestational Age; D006801:Humans; D015160:Hydrops Fetalis / Q000209:etiology; D007231:Infant, Newborn; D011247:Pregnancy; D012189:Retrospective Studies; D013617:Tachycardia, Supraventricular / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D055815:Young Adult
chemical_list: D000889:Anti-Arrhythmia Agents; D005424:Flecainide
keywords: Fetus; arrhythmia; flecainide; supraventricular tachycardia