Clinical course of 12 patients with fetal and/or neonatal tachyarrhythmia

Objective: The purpose of this study was to clarify the important points in managing the clinical course of fetal and/or neonatal tachyarrhythmia. Subjects and Method: Four cases of fetal tachyarrhythmia, 8 cases of neonatal tachyarrhythmia and 2 cases of fetal and neonatal tachyarrhythmia, which had been treated in our hospital since 2001. Median follow-up period after birth was 3 years and 7 months. The Following points were investigated retrospectively: (1) The clinical course of fetal tachyarrhythmia; and (2) The course after birth in each diagnostic category. Result: (1) Fetal tachyarrhythmia(atrial flutter, 2 cases; and supraventricular tachycardia, 2 cases). There was no case of hydrops and 3 cases underwent intra uterine treatment and regained sinus rhythm. (2) The course after birth in each diagnostic category (atrial flutter, 3 cases; atrial tachycardia, 2 cases; atrioventricular reentry tachycardia, 3 cases; atrioventricular nodal reentry tachycardia, 3 cases; and one case whose course was unknown). Responses to the treatment at the acute phase were good, but 6 cases relapsed and 2 to 4 attacks were observed in the cases of atrioventricular reentry tachycardia. Due to infection, 4 attacks of tachycardia were noticed. Conclusion: Maternal administration of an anti-arrhythmic drug was quite effective for fetal tachyarrhythmia, and fetal diagnosis was useful for managing relapse and for neonatal management. Cases of atrioventricular reentry tachycardia relapsed with higher frequency.