Abstract

A 9 hour old twin neonate, who was treated with flecainide in utero for fetal supraventricular tachycardia, presented with hypotension and a wide complex tachycardia concerning for flecainide toxicity. The patient was given a bolus of sodium bicarbonate with transient narrowing of her QRS complex. She was then intubated and started on a sodium bicarbonate drip with full resolution of her wide complex tachycardia within 24 hours. Work up showed no evidence for structural cardiac pathology or infection and she did not experience any further arrhythmias after termination of her presenting wide complex tachycardia. The patient was discharged home at 10 days of age and has had no further sequelae. This case report describes a novel presentation of in utero flecainide toxicity and summarizes the therapies available to treat this rare, but potentially lethal, presentation.

Details

Title
A case of neonatal single twin flecainide toxicity after therapeutic in utero exposure for fetal SVT
Author
Barot, Sabiha K 1 ; Seslar, Stephen P 2 ; Dolgner, Stephen 2 ; Mazor, Suzan S 3 

 Department of Emergency Medicine, University of Washington, Seattle, WA, USA 
 Department of Pediatrics, Division of Pediatric Cardiology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA 
 Department of Pediatrics, Division of Emergency Medicine, Seattle Children's Hospital, University of Washington, Seattle, WA, USA 
End page
44
Publication year
2017
Publication date
Dec 2017
Publisher
Taylor & Francis Ltd.
e-ISSN
24734306
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2196547129
Copyright
© 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.