Early prenatal management of a fetal ventricular tachycardia treated in utero by amiodarone with long term follow-up

Fetal cardiac arrhythmias are one of the causes of intra-uterine congestive heart failure and non-immune hydrops fetalis leading to fetal death. As ve ntricular tachycardia (VT) is rarely diagnosed in utero, it leads to emerge ncy deliveries. We report a prenatal diagnosis of fetal tachycardia at 20 w eeks of gestation associated with non-immune hydrops fetalis. The tachycard ia seemed to be supraventricular and was initially treated by digoxin and s otalol. The hydrops increased and sotalol was stopped in order to give the mother a high dose of amiodarone by mouth over a long period. Although the tachycardia, which the ECG recorded at birth revealed to be of ventricular origin, persisted but at a lower rate, the new treatment proved successful. The child is three years old now and health, though with persistent VT. In conclusion, fetal tachycardia with similar ventricular and atrial rates ca n be a VT and the drug of choice in this case seems to be amiodarone. Copyr ight (C) 2000 John Wiley & Sons, Ltd.