Reactions 1704, p27 - 2 Jun 2018 Left bundle branch block following in-utero exposure : case report A female neonate [exact age at event onset not stated] developed left bundle branch block following in-utero exposure to sotalol and amiodarone [duration of treatment to reaction onset not stated]. The female neonate’s 23-year-old mother was referred at 20-3/7 weeks gestational age of her second pregnancy due to fetal tachycardia and hydrops fetalis. Examinations led to the diagnosis of junctional ectopic tachycardia (JET) in the fetus. Subsequently, the fetus received treatment with transplacental digoxin and sotalol (maximum dose 480 mg/day). At 28-4/7 weeks gestational age, sotalol and digoxin were discontinued and oral amiodarone (600mg every 8 hours for 24 hours followed by 300mg every 12 hours) was given to her mother. At 38-1/7 weeks gestational age, the mother delivered the female neonate weighing 2.654kg through caesarean section. The APGAR scores were nine at both one and five minutes. An ECG showed junctional rhythm with rate of 115 bpm and left bundle branch block with QRS duration of 102ms. Brief periods of 2:1 AV block were observed during sleep. Additionally, the neonate developed moderate pulmonary hypertension, which was considered as related to her underlying condition. The female neonate was treated with propranolol, but the QRS remained prolonged for the following two days. The QRS duration normalised to 58ms by the second day of life, and the neonate achieved sustained sinus rhythm. She also received oxygen, which led to resolution of her pulmonary hypertension. She was discharged home on day of life 5. Three months later, she remained in sinus rhythm. Author comment: "Drugs used to treat fetal JET (flecainide, sotalol, and amiodarone) may produce transient left bundle branch block in the newborn." Zaidi SJ, et al. Prenatal diagnosis and management of junctional ectopic tachycardia. HeartRhythm Case Reports 3: 503-508, No. 11, Nov 2017. Available from: URL: http://doi.org/10.1016/j.hrcr.2017.07.022 - USA 803324055 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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