Sotalol in the treatment of fetal tachyarrhythmia.

BACKGROUND: Fetal tachycardia is an uncommon condition that if sustained may lead to fetal death. There is no consensus regarding the optimum treatment. The aim of this study was to evaluate the safety and efficacy of sotalol in the treatment of fetal tachycardia.

METHODS: This was a retrospective study of patients treated for fetal tachycardia with sotalol in a pediatric cardiology department over a ten-year period.

RESULTS: There were eight fetuses treated for supraventricular tachycardia and sotalol was used in six of them. Mean gestational age was 30 weeks. None of them had congenital heart disease; two fetuses had hydrops and one had hydrocephalus. All had supraventricular tachycardia and two had atrial flutter. Drug treatment was successful in establishing sinus rhythm in five of the six fetuses treated with sotalol and no adverse effects were recorded in the mothers. There were no deaths. Supraventricular tachycardia was present in three infants at birth.

CONCLUSIONS: In this study sotalol was successful and safe in the treatment of fetal tachycardia, but given the small sample size, more studies are needed to validate this conclusion.