Propanolol: una alternativa cercana para el tratamiento de la taquicardia supraventricular del feto / Propanolol: a close alternative for the treatment of fetal supraventricular tachycardia

RESUMEN

Las taquiarritmias son las alteraciones del ritmo cardiaco más comunes en el feto que pueden generar complicaciones fatales. En general, se recomienda tratamiento cuando son persistentes. Los medicamentos más usados para el tratamiento de esta arritmia en los fetos son digoxina, flecainida, sotalol y amiodarona. Si bien son efectivos, su aplicación en los fetos se fundamenta en las características mecánicas y no electrofisiológicas, con riesgo de generar arritmias fatales o de más difícil control. El fenómeno pro-arritmogénico y los efectos secundarios, comprometen también a las gestantes. La hipotensión y arritmias como el flutter auricular, exigen una vigilancia comprometida. Es importante considerar un medicamento más seguro que pueda ser útil en las formas más simples y comunes de taquiarritmias del feto...

ABSTRACT

Tachyarrhythmias are common alterations of cardiac rhythm in the fetus that may generate fatal complications. In general, when they are persistent, treatment is advised. The more used drugs for the treatment of this arrhythmia in fetuses are digoxin, flecainide, sotalol and amiodarone. Even though they are effective, its use in fetuses is based on mechanical and not in electrophysiological characteristics, with the risk of generating fatal arrhythmias or some of more difficult control. The pro-arrhythmogenic phenomenon and the secondary effects involve also the pregnant women. Hypotension and arrhythmias such as auricular flutter demand a compromised vigilance. It is important to consider a safer drug that may be useful in the simpler and more common forms of fetal tachyarrhythmias. Objetivo: to show by means of a clinical case and by revision of relevant articles, that propanolol can be part of the group of drugs for the treatment of fetal supraventricular tachycardia. A series of alternatives have been imposed with adequate results; nevertheless, these are exigent in its knowledge and control and definitely not exempt of risks. Our objective is to show that propanolol is still an alternative for specific cases of tachyarrhythmias in fetuses, isolated or combined with other drugs.