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Cited by 237Cardiac Arrhythmias and TreatmentsCardiac electrophysiology and arrhythmiasCongenital Heart Disease Studies

The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.

Comparison of Transplacental Treatment of Fetal Supraventricular Tachyarrhythmias With Digoxin, Flecainide, and Sotalol: Results of a Nonrandomized Multicenter Study

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Jaeggi, Edgar T., Carvalho, Julene S., De Groot, Ernestine, Api, Olus, Clur, Sally-Ann B., Rammeloo, Lukas, McCrindle, Brian W., Ryan, Greg, Manlhiot, Cedric, Blom, Nico A.·2011·Circulation
DOI 10.1161/circulationaha.111.026120
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Abstract

BACKGROUND: Fetal tachyarrhythmia may result in low cardiac output and death. Consequently, antiarrhythmic treatment is offered in most affected pregnancies. We compared 3 drugs commonly used to control supraventricular tachycardia (SVT) and atrial flutter (AF). METHODS AND RESULTS: We reviewed 159 consecutive referrals with fetal SVT (n=114) and AF (n=45). Of these, 75 fetuses with SVT and 36 with AF were treated nonrandomly with transplacental flecainide (n=35), sotalol (n=52), or digoxin (n=24) as a first-line agent. Prenatal treatment failure was associated with an incessant versus intermittent arrhythmia pattern (n=85; hazard ratio [HR]=3.1; P<0.001) and, for SVT, with fetal hydrops (n=28; HR=1.8; P=0.04). Atrial flutter had a lower rate of conversion to sinus rhythm before delivery than SVT (HR=2.0; P=0.005). Cardioversion at 5 and 10 days occurred in 50% and 63% of treated SVT cases, respectively, but in only 25% and 41% of treated AF cases. Sotalol was associated with higher rates of prenatal AF termination than digoxin (HR=5.4; P=0.05) or flecainide (HR=7.4; P=0.03). If incessant AF/SVT persisted to day 5 (n=45), median ventricular rates declined more with flecainide (-22%) and digoxin (-13%) than with sotalol (-5%; P<0.001). Flecainide (HR=2.1; P=0.02) and digoxin (HR=2.9; P=0.01) were also associated with a higher rate of conversion of fetal SVT to a normal rhythm over time. No serious drug-related adverse events were observed, but arrhythmia-related mortality was 5%. CONCLUSION: Flecainide and digoxin were superior to sotalol in converting SVT to a normal rhythm and in slowing both AF and SVT to better-tolerated ventricular rates and therefore might be considered first to treat significant fetal tachyarrhythmia.

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Authors
Jaeggi, E. T., Carvalho, J. S., De Groot, E., Api, O., Clur, S.-A. B., Rammeloo, L., McCrindle, B. W., Ryan, G., Manlhiot, C., & Blom, N. A.
Affiliations
  • Mount Sinai Hospital (CA)
  • From the Hospital for Sick Children (E.T.J., B.W.M., C.M.) and Mount Sinai Hospital (G.R.), University of Toronto, Toronto, ON, Canada; Royal Brompton and St. George's Hospitals, London, UK (J.S.C., O.A.); Leiden University Medical Center, Leiden, the Netherlands (E.D.G., N.A.B.); Academic Medical Center, Amsterdam, the Netherlands (S.-A.B.C.); and Free University Medical Center, Amsterdam, the Netherlands (L.R.).
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2011-10-18
Volume
124
Issue
16
Pages
1747-1754
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.111.026120
OpenAlex
W2096612114
Cited by
237
References
30
Citations by year
2026: 16 · 2025: 16 · 2024: 11 · 2023: 19 · 2022: 15 · 2021: 15 · 2020: 12 · 2019: 11 · 2018: 15 · 2017: 18 · 2016: 16 · 2015: 18 · 2014: 17 · 2013: 19 · 2012: 18
FWCI
12.05
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Leiden Repository (Leiden University) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
Keywords
fetal supraventricular tachycardia, fetal atrial flutter, digoxin, flecainide, sotalol, hydrops fetalis, ventricular rate control, drug safety in pregnancy
MeSH terms
Anti-Arrhythmia Agents, Digoxin, Drug Evaluation, Female, Fetal Diseases, Flecainide, Humans, Pregnancy, Retrospective Studies, Sotalol, Tachycardia, Supraventricular, Treatment Outcome, Fetal Therapies

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