Download Fetal tachycardia - Evelina London Children`s Hospital

Fetal tachycardia
This leaflet explains more about fetal tachycardia.
If you have any further questions, please speak to a doctor or nurse caring for you.
What is tachycardia?
Tachycardia is an abnormally fast heart rate. The normal fetal heart rate is between 120 and
170 beats per minute. Typically, an abnormally fast heart rate is over 200 beats per minute.
The heart is made up of four chambers: two upper chambers called atriums and two lower
chambers called ventricles. It is the top two chambers of the heart (atriums) that set the pace of
the heart, and normally the ventricles only respond to electrical impulses from the atriums.
In some fetuses, the atriums and ventricles are both beating fast but at the same rate
(supraventricular tachycardia). In others, the atriums beat exceedingly fast (over 300 beats per
minute), much faster than the ventricles (atrial flutter). Other rhythm disturbances may occur but
are much rarer.
How does the fast heart rate affect my baby?
In some situations, as a result of the fast heart rate, fluid may gather inside the baby (hydrops).
This can make the fast heart rate more difficult to control. We may need to reassess the
management if we are unable to control the baby’s heart rate by our usual method.
What treatments are available?
In most cases we can control the fast heart rate by giving medication to the mother, which
passes through the placenta to the baby. We perform a simple test on your heart called an
electrocardiogram (ECG) before prescribing the medication. Some drugs can take two to three
weeks before they are effective in reducing the baby’s heart rate. Usually treatment is given as
an outpatient and does not need a stay in hospital. During this time it is important that we
monitor the medication before we achieve control of the tachycardia. The aim of treatment is to
control the rhythm of the heart, which in most cases allows a normal delivery at term (after 37
weeks). We will take blood samples from you to check the levels of the drug in your body, to
make sure that they are within the correct range. Occasionally, we may have to try more than
one medication before we achieve control of the tachycardia. The type of treatment selected
depends on a number of factors including the nature of the tachycardia, how many weeks
pregnant you are, and signs of fluid collection in the baby (hydrops).
Can I be monitored at my local hospital?
Once we have controlled the rhythm of your baby’s heart you will be managed jointly between
your local hospital and ourselves. You should continue taking the prescribed medication until
your baby is born. In the majority of cases, a normal delivery at your local hospital is possible.
1 of 2
What happens after the baby is born?
After your baby is born we recommend that your baby has an electrocardiogram (ECG).
Occasionally we may find an underlying cause for the fast heart rate after birth, which may need
more investigation. Our policy is to recommend that your baby be prescribed medication for
approximately six months to one year to prevent a recurrence of the fast heart rate. Following
this, in most cases, medication can be withdrawn without the tachycardia returning.
Useful sources of information
Antenatal Results and Choices (ARC) is a registered charity that offers continued support and
advice to parents who face difficult decisions regarding foetal abnormalities. They have
extensive experience in helping parents at this time and aim to offer both support and advice in
meeting your unique needs.
t: 020 7631 0285 w: www.arc-org.uk
Evelina Children’s Heart Organisation (ECHO) is a charity that supports the families of
children with congenital heart disease who receive treatment at the Evelina Children’s Hospital.
They have a rota of trained prenatal support volunteers who offer comfort and reassurance at
this stressful time. ECHO also sponsors specialist antenatal classes for parents of heart babies
to be treated at the Evelina Children’s Hospital.
t: 07730 146 154 e: [email protected] w: www.echo-evelina.org.uk
Little Hearts Matter (LHM) is a national charity that offers support and information to families
where a single ventricle heart condition has been diagnosed.
t: 0121 455 8982 e: [email protected] w: www.lhm.org.uk
Heartline is a national charity that provides support and help for children with congenital heart
conditions and their families.
t: 01276 707 636 w: www.heartline.org.uk
Children's Heart Federation (CHF) is a national charity and the umbrella body for voluntary
organisations working to meet the needs of children and young people with congenital and
acquired heart conditions and their families.
t: (freephone infoline) 0808 808 5000 (9.30am - 4.30pm Mon to Fri)
w: www.childrens-heart-fed.org.uk
British Heart Foundation (BHF) is a national charity providing information and support on
anything heart-related.
t: (helpline local rate) 0300 330 3311 w: www.bhf.org.uk
Contact us
If you have any questions or concerns, please contact fetal cardiology on 020 7188 2308
(Monday to Friday, 9am to 5.30pm).
Patient Advice and Liaison Service (PALS) – To make comments or raise concerns about the
Trust’s services, please contact PALS. Ask a member of staff to direct you to the PALS office or:
t: 020 7188 8801 at St Thomas’ t: 020 7188 8803 at Guy’s e: [email protected]
Language support services – If you need an interpreter or information about your care in a
different language or format, please get in touch using the following contact details.
t: 020 7188 8815 fax: 020 7188 5953
Leaflet number: 3654/VER1
2 of 2
Date published: April 2013
Review date: April 2016
© 2013 Guy’s and St Thomas’ NHS Foundation Trust