[Supraventricular tachycardia and premature atrial contractions in fetus]

Foetal arrhythmias are encountered in 1-2% of pregnancies and 10% of these are associated with some form of foetal mortality or morbidity, including structural heart disease, foetal death and neurological complications. The most frequent types of arrhythmia are supraventricular arrhythmias of which the innocent premature atrial depolarisations make up 85%; 10% are tachycardias with a foetal heart rate of over 180/min. Echocardiographic evaluation is required to exclude associated structural abnormalities and to decide whether therapy is required. The prognosis of a foetus with tachycardia depends on the presence of associated pathology, the type of arrhythmia, the presence of foetal hydrops, the heart rate and the adequacy of treatment. The treatment of foetal tachycardia depends on the type of the tachycardia and since most tachycardias are of supraventricular origin the therapeutic armamentarium includes digoxin, sotalol and flecainide, each with its specific side effects. Foetal tachycardia patients require immediate diagnosis and if necessary therapy in a specialized center.