THE EFFECT OF FLECAINIDE ACETATE ON FETAL HEART-RATE-VARIABILITY - A CASE-REPORT

Background: Fetal supraventricular tachycardia is most often treated b y maternal application of digoxin. A drug used for second-choice thera py is flecainide acetate. Case: For a case in which maternal digoxin t herapy failed, flecainide caused a lowering of the fetal heart rate (F HR) but, simultaneously, variability and accelerations nearly disappea red. The fetus demonstrated a normal movement pattern. Fetal well-bein g during delivery was assessed by regular ultrasound observations of f etal movements. Flecainide was not continued after birth, and digoxin therapy was started when tachycardia reappeared. The heart rate change d into a reactive pattern 5 days after birth. Around that time, flecai nide levels in the neonatal serum were below the limit of detection. C onclusion: Flecainide use can cause the absence of accelerations and p oor variability in the FHR.