Fetal supraventricular tachycardia

Last revised by David Carroll on 2 Aug 2021

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Carroll D, Sharma R, et al. Fetal supraventricular tachycardia. Reference article, Radiopaedia.org (Accessed on 18 Apr 2024) https://doi.org/10.53347/rID-13763

DOI:

https://doi.org/10.53347/rID-13763

Permalink:

https://radiopaedia.org/articles/13763

rID:

13763

Article created:

14 May 2011, Yuranga Weerakkody ◉

Disclosures:

At the time the article was created Yuranga Weerakkody had no recorded disclosures.

View Yuranga Weerakkody's current disclosures

Last revised:

2 Aug 2021, David Carroll ◉

Disclosures:

At the time the article was last revised David Carroll had no recorded disclosures.

View David Carroll's current disclosures

Revisions:

7 times, by 7 contributors - see full revision history and disclosures

Systems:

Cardiac, Obstetrics

Tags:

cases

Synonyms:

Fetal supraventricular tachycardia (SVT)
Fetal SVT
Fetal supra-ventricular tachycardia
Fetal supraventricular tachycardias

Fetal supraventricular tachycardia (SVT) is considered the most common type of fetal tachyarrhythmia and can account for 60-90% of such cases.

It has a typical ventricular rate of 230-280 beats per minute (bpm) ¹ and is
often associated with an accessory AV conduction pathway. There is a 1-to-1 atrioventricular conduction. A supraventricular tachycardia is only rarely associated with intra- or extra-cardiac anomalies (in contrast to other tachyarrhythmias).

Associations

Wolff-Parkinson-White syndrome: may be present in ~10% of cases

Radiographic features

Ultrasound/echocardiography

The diagnosis of supraventricular tachycardia can be established using M-mode echocardiography, which may demonstrate paroxysms of atrial tachycardia in the range of 230 - 280 beats per minute (BPM), often following an extra-systole. M-mode echocardiography uses a sampling line placed across atrial and ventricular walls and times electromechanical events in the fetal cardiac cycle. However, it is often not possible to completely identify its precise electropathophysiologic mechanism by this method.

Treatment and prognosis

The management of the fetus with a normal anatomical survey and supraventricular tachycardia is dependent upon the gestational age at diagnosis, and the presence or absence of hydrops fetalis. Digoxin is often considered the drug of first choice. Compared with other arrhythmias, the overall perinatal mortality rate is considered low at ~5-10% (particularly if there are no complications such as the development of hydrops fetalis).