FETAL SUPRAVENTRICULAR TACHYCARDIA TREATED WITH SOTALOL

This retrospective study (1991-95) presents our experience with sotalo l in the treatment of 14 foetuses with supraventricular tachycardia (S VT). SVT was diagnosed in a structurally normal heart at a gestational age of 24-35 (median 28) weeks. In eight foetuses, hydrops was eviden t at presentation. In all patients pharmacological conversion with dig oxin was tried before sotalol treatment was started. Sotalol was given orally to the mothers in a dose of 80-160 mg x 2. Cardioversion was o btained in 10 foetuses. In seven of these patients re-entry tachycardi a and in five pre-excitation could be documented after birth. In two f oetuses not responding to sotalol a long RP tachycardia was demonstrat ed; even when using digoxin, sotalol, flecainide and/or propafenone in different combinations after birth complete suppression of the arrhyt hmia was not obtained. Two severely hydropic foetuses died 1 and 10 d, respectively, after starting with sotalol. The 12 surviving infants w ere doing well except for one infant, with a cerebral lesion probably related to the arrhythmia. These findings demonstrate that sotalol can be useful in the treatment of foetal SVT.