Allan L D, Chita S K, Sharland G K, Maxwell D, Priestley K
Department of Perinatal Cardiology, Guy's Hospital, London.
Br Heart J. 1991 Jan;65(1):46-8. doi: 10.1136/hrt.65.1.46.
Fourteen mothers were treated with flecainide for fetal atrial tachycardias associated with intrauterine cardiac failure. Twelve of the 14 fetuses responded by conversion to sinus rhythm. One of the 12 fetuses subsequently died in utero. The remaining fetuses suffered no morbidity and were alive and well 3 months to 2 years after delivery. The two fetuses in whom atrial tachycardia did not convert with flecainide were successfully treated with digoxin. These results compare favourably with previous forms of antiarrhythmic treatment. After recent reports of the side effects of flecainide treatment, however, it has been advised that this drug should be confined to high risk patients and those with life threatening arrhythmias. The use of flecainide for fetal arrhythmias should be limited to patients with severe fetal hydrops and supraventricular tachycardias. It should not be the first drug of choice in atrial flutter.
14名患有与宫内心力衰竭相关的胎儿房性心动过速的母亲接受了氟卡尼治疗。14名胎儿中有12名通过转为窦性心律作出反应。12名胎儿中有1名随后在子宫内死亡。其余胎儿未出现并发症，在分娩后3个月至2年时存活且状况良好。2名使用氟卡尼未能使房性心动过速转复的胎儿用地高辛成功治疗。这些结果优于先前的抗心律失常治疗方式。然而，在近期有关于氟卡尼治疗副作用的报道后，有人建议该药应仅限于高危患者和患有危及生命心律失常的患者使用。氟卡尼用于胎儿心律失常应仅限于患有严重胎儿水肿和室上性心动过速的患者。它不应作为心房扑动的首选药物。
