Fetal Therapy for Severe Drug-Resisted Tachyarrhythmia With Progressive Hydrops by Fetoscopic Transesophageal Pacing: A Successful Attempt in Single Chinese Fetal Medicine Center.

IF 2.7 2区医学 Q2 GENETICS & HEREDITY

Prenatal Diagnosis Pub Date : 2025-01-07 DOI:10.1002/pd.6745

Hao Wang, Wenfei Luo, Chen Gongli

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引用次数: 0

Abstract

Objective: To describe the outcome of a case of severe drug-resistant fetal tachyarrhythmia with progressive hydrops treated with fetoscopic transesophageal pacing (FTEP).

Method: A case of fetal tachyarrhythmia complicated by progressive hydrops is presented. The fetus, diagnosed at 26⁺² weeks of gestation, had supraventricular tachycardia with a mechanism suggestive of atrial reentry. Maternal treatment included digoxin, sotalol and amiodarone, which were ineffective in controlling the arrhythmia. After failure of pharmacological therapy, FTEP was performed.

Results: A male baby was delivered by cesarean section, with the Apgar scores of 10 at 1 min, 5 and 10 min at 35⁺² weeks of gestation. An initial neonatal electrocardiogram demonstrated normal sinus rhythm. Follow-up is now up to 1 year, without tachyarrhythmia or cardiac dysfunction.

Conclusion: FTEP offers a potential rescue therapy for cases of severe drug-resistant fetal tachyarrhythmia associated with progressive fetal hydrops and cardiac dysfunction.

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经食管胎镜起搏胎儿治疗进行性心律失常的成功尝试。

目的：介绍1例经食管起搏（FTEP）治疗严重耐药胎儿心律失常伴进行性积液的疗效。方法：报告1例胎儿心律失常并发进行性积液。胎儿在妊娠26+2周时被诊断为室上性心动过速，其机制提示心房再入。产妇使用地高辛、索他洛尔和胺碘酮治疗，对控制心律失常无效。药物治疗失败后，行FTEP。结果：1例男婴经剖宫产分娩，35+2周Apgar评分分别为1 min、5 min和10 min。新生儿初始心电图显示窦性心律正常。随访1年，无心律失常或心功能障碍。结论：FTEP为严重耐药胎儿心律失常伴进行性胎儿水肿和心功能障碍提供了一种潜在的抢救治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prenatal Diagnosis 医学-妇产科学

CiteScore

5.80

自引率

13.30%

发文量

204

审稿时长

2 months

期刊介绍： Prenatal Diagnosis welcomes submissions in all aspects of prenatal diagnosis with a particular focus on areas in which molecular biology and genetics interface with prenatal care and therapy, encompassing: all aspects of fetal imaging, including sonography and magnetic resonance imaging; prenatal cytogenetics, including molecular studies and array CGH; prenatal screening studies; fetal cells and cell-free nucleic acids in maternal blood and other fluids; preimplantation genetic diagnosis (PGD); prenatal diagnosis of single gene disorders, including metabolic disorders; fetal therapy; fetal and placental development and pathology; development and evaluation of laboratory services for prenatal diagnosis; psychosocial, legal, ethical and economic aspects of prenatal diagnosis; prenatal genetic counseling