1/34. adenosine triphosphate for cardioversion of supraventricular tachycardia in two hydropic fetuses.OBJECTIVE: We performed a retrospective study to check the effectiveness of adenosine triphosphate (Striadyne) for cardioversion of fetal supraventricular tachycardia (SVT) and to evaluate neonatal outcome after prenatal treatment of severe SVT with fetal hydrops. methods: Two hydropic fetuses with SVT were treated with Striadyne injection into the umbilical vein, as an additional treatment to the digoxin given intravenously to the mother. Both fetuses were in severe condition, with ultrasound, Doppler and laboratory signs of fetal distress and congestive heart failure. RESULTS: Sinus rhythm was obtained in both cases for different periods of time, without side effects of Striadyne. The children survived. There were severe cardiac and neurologic problems after delivery. CONCLUSIONS: Striadyne was an effective drug in converting SVT to the sinus rhythm in hydropic fetuses. digoxin was useless in these fetuses in spite of the therapeutic level which was obtained in both mothers. We suppose that fetal SVT causing fetal hydrops could be the reason of brain damage, and intensive antiarrhythmic treatment seemed to be necessary.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |
2/34. Supraventricular tachycardia with hydrops in a 27-week premature baby.A 27-week baby with antenatally diagnosed supraventricular tachycardia (SVT) and hydrops fetalis was delivered by emergency caesarean section because of severe fetal bradycardia. The mother was on flecanide to control the fetal SVT. The baby was hydropic at birth and required prolonged ventilatory support. On day 6, he developed acute renal failure for which peritoneal dialysis was done. On day 23, he developed several episodes of supraventricular tachycardia (SVT) which did not respond to intravenous adenosine and amiodarone and ultimately required intravenous flecanide. This case report highlights the management of a critically ill premature hydropic baby with resistant SVT, and the successful outcome.- - - - - - - - - - ranking = 0.066012489596147keywords = section (Clic here for more details about this article) |
3/34. Successful digoxin therapy of fetal supraventricular tachycardia in a triplet pregnancy.BACKGROUND: Fetal supraventricular tachycardia is a rare complication of pregnancy associated with cardiac failure, hydrops, and fetal death. If no underlying cardiac defects are present, medical management with digoxin has been successful. CASE: A young woman with a triplet pregnancy presented at 23 17 weeks' gestation for routine Doppler auscultation which suggested fetal supraventricular tachycardia, confirmed by M-mode echocardiography. She was treated with oral digoxin for the remainder of her pregnancy with subsequent conversion of the tachycardic triplet to normal sinus rhythm with occasional premature atrial beats. After delivery, the triplet previously demonstrating supraventricular tachycardia had a normal sinus rhythm. CONCLUSION: digoxin might be used safely and successfully to treat fetal supraventricular tachycardia in multifetal pregnancies.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |
4/34. Right atrial reduction for tachyarrhythmias in Ebstein's anomaly in infancy.A 20-month-old girl with Ebstein's anomaly developed supraventricular paroxysmal tachycardia, which seemed to be a result of the wall tension of the giant right atrium. Right atrial resection reduced the wall tension and overall dimensions of the right atrium and finally resolved the tachycardia and ectopic electrical conduction. Six-year follow-up electrocardiograms confirmed continuing normal sinus rhythm without occurrence of supraventricular paroxysmal tachycardia or other ectopic electrical activity The follow-up echocardiograms showed the size of the right atrium to be unchanged from the time of operation. There are few data in the available literature about performing right atriotomy to resolve a tachyarrhythmia associated with Ebstein's anomaly and none, to the best of our knowledge, about performing right atrial resection for this purpose.- - - - - - - - - - ranking = 0.13202497919229keywords = section (Clic here for more details about this article) |
5/34. Short-acting beta-adrenergic blockade and the fetus. A case report.An infant was born to a woman who received intravenous esmolol for intrapartum supraventricular tachyarrhythmia. Despite the very short acting and cardio-selective beta-1 adrenergic blockade induced by that agent, neonatal effects can occur up to 48 hours after delivery.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |
6/34. Holter documented sudden death in a patient with an implanted defibrillator.A 68-year-old man with recurrent attacks of monomorphic ventricular tachycardia (VT) received a pacer cardioverter defibrillator featuring antitachycardia pacing and cardioversion/defibrillation. Over 300 episodes of VT were successfully terminated by antitachycardia pacing. During Holter monitoring the patient experienced supraventricular tachycardia with delivery of multiple antitachycardia pacing, cardioversion, and defibrillation therapies ending with the death of the patient. The following factors played a role in the unfortunate outcome of this patient: 1. triggering of VT therapy by an unexpected high sinus rate; 2. atrial fibrillation induced by cardioversion therapy; 3. a gradual and continuous increase in rate during atrial fibrillation possibly caused by repeated VT and ventricular fibrillation therapies and/or by a thrombus, found at autopsy, in a bypass graft; and 4. the limited ability of presently available defibrillators to distinguish between ventricular and supraventricular arrhythmias.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |
7/34. Radiofrequency catheter ablation in drug refractory maternal supraventricular tachycardias in advanced pregnancy.BACKGROUND: Treatment of maternal tachyarrhythmias in pregnancy is a major clinical issue. Pharmacological treatment raises important concerns regarding partial efficacy and side effects. Radiofrequency ablation of arrhythmogenic substrate has rarely been performed during pregnancy because of the fetal risks related to x-ray exposure and potential fetomaternal procedural complications. CASES: Three women affected by supraventricular tachycardias refractory to pharmacological therapy underwent successful radiofrequency catheter ablation at 29 to 30 weeks' pregnancy. All patients had cesarean delivery of newborns with normal Apgar scores. CONCLUSION: Radiofrequency catheter ablation is an effective treatment of drug refractory maternal supraventricular tachycardias in advanced pregnancy. Further studies are required to establish its long-term fetal safety.- - - - - - - - - - ranking = 1keywords = delivery (Clic here for more details about this article) |
8/34. Supraventricular tachycardia in pregnancy.We present four cases of supraventricular tachycardia in pregnancy of varied aetiology. risk factors for the development of supraventricular tachycardia and options for obstetric anaesthetic management, during pregnancy, labour, and at Caesarean section are discussed. We recommend the use of adenosine as first line therapy.- - - - - - - - - - ranking = 0.066012489596147keywords = section (Clic here for more details about this article) |
9/34. Simultaneous supraventricular tachycardias in both fetuses of a twin gestation.BACKGROUND: Fetal supraventricular tachycardia confers an increased risk of cardiac failure, hydrops, and eventual intrauterine death. Although protocols for prenatal anti-arrhythmic treatment are now well established, few published reports discuss this condition in the setting of multiple pregnancies. CASE REPORT: A 20-year-old primigravida woman with a twin pregnancy presented at 31 weeks of gestation for routine obstetrical check-up which revealed simultaneous supraventricular tachycardia in both fetuses. She was treated with oral digoxin, resulting in successful cardioversion in both of the fetuses, which was maintained until they were delivered by caesarian section at 38 weeks gestation. However, several hours after birth, tachyarrhythmias recurred in each of the infants. Combined disopyramide therapy with digoxin was necessary to control their heart rates. CONCLUSION: The treatment of arrhythmia in fetuses of a multiple gestation presents unique issues, particularly when diagnosed prior to fetal lung maturity.- - - - - - - - - - ranking = 0.066012489596147keywords = section (Clic here for more details about this article) |
10/34. Termination of supraventricular tachycardia with intravenous adenosine in a pregnant woman with wolff-parkinson-white syndrome.BACKGROUND: pregnancy is associated with an increased frequency of arrhythmias in women with wolff-parkinson-white syndrome. We describe the use of intravenous (IV) adenosine for the acute termination of a narrow complex tachycardia in a pregnant patient with this syndrome. CASE: A 26-year-old woman with known wolff-parkinson-white syndrome presented with dizziness, palpitations, and a narrow complex supraventricular tachycardia. We used IV adenosine to convert the arrhythmia to a normal sinus rhythm. During labor, the patient again developed a narrow complex supraventricular tachycardia, and fetal monitoring revealed recurrent deep variable decelerations. Intravenous adenosine resulted in conversion to sinus rhythm and restoration of the fetal heart rate to normal. Cesarean delivery produced a healthy male infant. CONCLUSIONS: Adenosine is effective in rapidly terminating maternal narrow complex tachyarrhythmias before and during delivery in women with wolff-parkinson-white syndrome. It can also treat fetal bradycardia resulting from the maternal arrhythmia.- - - - - - - - - - ranking = 2keywords = delivery (Clic here for more details about this article) |
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