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BACKGROUND Efficacy of flecainide acetate for the treatment of fetal supraventricular tachycardia with cardiac failure was reported. METHODS For a case in which maternal digoxin therapy failed, flecainide acetate (400 mg/day) is used from 27 weeks. Cardioversion with improved cardiac function occurred 6 days after treatment. Fetal serum flecainide acetate level was 292 ng/ml which was 64% of the maternal level (453 ng/ml). No adverse maternal side effects were noted with 11 weeks of therapy. A vigorous male baby, weighing 3,610 g, Apgar 8/9, Ua-pH 7.24, was born. He is now 1 year of age and in good condition with medication of 5 mg/kg flecainide acetate. CONCLUSIONS Flecainide acetate seemed to be safe for both mother and fetus, and effective for the treatment of fetal supraventricular tachycardia which is refractory to transplacental digoxin therapy.
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