Treatment of Fetal Supraventricular Tachycardia

Fetal arrhythmia is a common reason for referral to fetal cardiology. Fetal supraventricular tachycardia can be subdivided into several groups with the most common being re-entrant supraventricular tachycardia and atrial flutter. Fetal tachycardia can lead to hydrops fetalis, which increases the risk of fetal demise, perinatal morbidities, and premature delivery. The diagnosis of fetal tachycardia can be a challenge as a traditional electrocardiogram cannot be completed on a fetus, and other methods must be used by fetal echocardiogram. Several retrospective studies have been completed to determine the best treatment; however, there continues to be no consensus on the best option. Digoxin, flecainide, and sotalol are commonly used and have favorable results depending on gestational age, fetal well-being, and presence of hydrops. Treatment in a timely manner can convert supraventricular tachycardia to a normal fetal heart rate, and hydrops can resolve with delivery at term if the proper medications are used.