Sonesson S E, Fouron J C, Wesslen-Eriksson E, Jaeggi E, Winberg P
Department of Woman and Child Health, St Göran's Children's Hospital, Karolinska Institute, Stockholm, Sweden.
Acta Paediatr. 1998 May;87(5):584-7. doi: 10.1080/08035259850158335.
This retrospective study (1991-95) presents our experience with sotalol in the treatment of 14 foetuses with supraventricular tachycardia (SVT). SVT was diagnosed in a structurally normal heart at a gestational age of 24-35 (median 28) weeks. In eight foetuses, hydrops was evident at presentation. In all patients pharmacological conversion with digoxin 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 obtained in 10 foetuses. In seven of these patients re-entry tachycardia and in five pre-excitation could be documented after birth. In two foetuses not responding to sotalol a long RP tachycardia was demonstrated; even when using digoxin, sotalol, flecainide and/or propafenone in different combinations after birth complete suppression of the arrhythmia was not obtained. Two severely hydropic foetuses died 1 and 10 d, respectively, after starting with sotalol. The 12 surviving infants were 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.
这项回顾性研究（1991 - 1995年）介绍了我们使用索他洛尔治疗14例胎儿室上性心动过速（SVT）的经验。SVT是在孕龄24 - 35周（中位数28周）、心脏结构正常的胎儿中诊断出来的。8例胎儿在就诊时出现明显水肿。在所有患者中，在开始索他洛尔治疗前均尝试用地高辛进行药物转复。给母亲口服索他洛尔，剂量为80 - 160mg×2次。10例胎儿实现了心律转复。其中7例患者出生后可记录到折返性心动过速，5例可记录到预激。2例对索他洛尔无反应的胎儿表现为长RP心动过速；即使在出生后使用地高辛、索他洛尔、氟卡尼和/或普罗帕酮的不同组合，心律失常也未完全得到抑制。2例严重水肿的胎儿在开始使用索他洛尔后分别于1天和10天后死亡。12例存活婴儿情况良好，只有1例婴儿有脑部病变，可能与心律失常有关。这些发现表明索他洛尔可用于治疗胎儿SVT。
