Fetal tachycardia, characterized by a fetal heart rate exceeding 180 beats per minute, occurs in about 1% of pregnancies. While most fetal arrhythmias are benign, sustained fetal tachyarrhythmias like Supraventricular Tachycardia (SVT) and Atrial Flutter require prompt treatment. These conditions pose severe risks, including fetal hydrops and intrauterine demise. This thesis investigates the efficacy and safety of first-line transplacental treatments (Digoxin, Amiodarone, Flecainide, Sotalol), where antiarrhythmic medications are administered to the mother to reach the fetus through the placenta. Emphasizing individualized treatment plans and careful maternal-fetal monitoring, it highlights the importance of comprehensive maternal evaluations and continuous monitoring to prevent toxicity. Future advancements in diagnostic technologies and new antiarrhythmic drugs hold promise for improving outcomes in fetal tachycardia management.