{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:48:00Z","timestamp":1792111680744,"version":"4.4.0"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the efficacy and safety of transplacental flecainide and\/or digoxin for fetal tachyarrhythmias when sotalol is unavailable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We evaluated transplacental flecainide, digoxin, or combination therapy in a retrospective and prospective cohort across two Thai tertiary centers. Outcomes were classified as complete cardioversion, partial response (rate control), or treatment failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 24 eligible pregnancies, 14 (58.3%) had supraventricular tachycardia (SVT), 8 (33.3%) had atrial flutter (AFL), and 2 (8.3%) had ventricular tachycardia (VT). Overall, clinical responses occurred in 91.7% (22\/24) of fetuses. Flecainide monotherapy achieved 100% (9\/9) complete cardioversion in SVT, compared with 50% (1\/2) for digoxin. SVT combination therapy (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a03) yielded 1 complete and 1 partial response. Among 7 flecainide\u2010treated AFL cases, 5 (71.4%) achieved rate control and 2 (28.6%) achieved cardioversion; one digoxin\u2010treated case fully converted. Flecainide resolved 1 of 2 VT cases (50%). Response rates were unaffected by hydrops, gestational age, or cardiac defects (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.087\u20131.000). Maternal adverse events were mild and required no treatment discontinuation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Transplacental flecainide demonstrates high efficacy in SVT and effective rate control with preserved cardiac function in AFL. Its favorable safety profile makes it a practical alternative for first\u2010line therapy where sotalol is unavailable and flecainide monitoring is infeasible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pd.70278","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:50:36Z","timestamp":1792101036000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transplacental Flecainide and\/or Digoxin for Fetal Tachyarrhythmias: Therapeutic Efficacy and Clinical Experience"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3806-4065","authenticated-orcid":false,"given":"Mukpradab","family":"Darakamas","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Department of Obstetrics and Gynaecology Faculty of Medicine Siriraj Hospital Mahidol University  Bangkok 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