Fetal arrhythmias: Natural history and management

Vergani, Patrizia; Mariani, Eloisa; Ciriello, Elena; Locatelli, Anna; Strobelt, Nicola; Galli, Maria Grazia; Ghidini, Alessandro

doi:10.1016/j.ultrasmedbio.2004.10.001

Cited by 30 publications

(47 citation statements)

References 32 publications

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“…The frequency of congenital heart malformations in our study was 0.78%, which is the same as that in the general population, and is in agreement with the findings of Copel et al 20 and Vergani et al 24. The need for a full echocardiographic examination in cases of fetal extrasystoles might therefore be questioned.…”

Section: Discussionsupporting

confidence: 92%

“…The vast majority of fetuses with atrial or ventricular extrasystoles have an uneventful pre‐ and postnatal outcome in contrast to fetuses with tachy‐ and brady‐arrhythmias, which may be of more hemodynamic significance4, 21. Less than 1–5% of fetuses develop tachycardia, the risk apparently being highest in fetuses with multiple blocked atrial ectopic beats4, 20, 22–24. Premature ventricular contractions potentially lead to ventricular tachycardia.…”

Section: Discussionmentioning

confidence: 99%

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Hepatic venous Doppler in the evaluation of fetal extrasystoles

Saemundsson

Johansson

Wenling

et al. 2011

Ultrasound in Obstet & Gyne

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Hepatic venous Doppler in the evaluation of fetal extrasystoles

Saemundsson

Johansson

Wenling

et al. 2011

Ultrasound in Obstet & Gyne

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“…The spectrum of complex congenital heart disease in our series was similar to that reported in the literature, namely left atrial isomerism, congenitally corrected transposition of the great arteries or complete atrioventricular septal defect [17][18][19][20][21] . This significantly and adversely influenced the outcome of these fetuses [4,[21][22][23] .…”

Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis, Management and Outcome of Fetal Dysrhythmia: A Tertiary Fetal Medicine Centre Experience over an Eight-Year Period

Rasiah

Ewer²,

Miller³

et al. 2011

Fetal Diagn Ther

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Objective: To review the prenatal diagnosis, management and outcome of fetal dysrhythmia. Subjects and Methods: Prenatal diagnosis, management and outcomes of fetuses with dysrhythmia were reviewed retrospectively (01/01/1997 to 31/12/2004). Results: Over an 8-year period, 318 pregnant mothers were referred for assessment of suspected fetal dysrhythmias. Median gestation was 30 weeks (range 19–41). Fetal dysrhythmia was identified in 182 (57%) and classified as: (i) 126 atrial extrasystoles; (ii) 26 tachyarrhythmia, and (iii) 30 bradyarrhythmia. Of the fetuses with tachyarrhythmia, 23 had supraventricular tachycardia (SVT), 2 atrial flutter and 1 sinus tachycardia. One death associated with severe hydrops occurred in the tachyarrhythmia group. 19 cases of SVT were successfully treated in utero. Both cases of atrial flutter required direct current cardioversion in the neonatal period. In the bradyarrhythmia group, there were 15 isolated cases and 10 cases associated with congenital heart disease, with 73 and 20% survival, respectively. Conclusions: Benign atrial extrasystoles are the commonest cause for referral and assessment of fetal dysrhythmia. The overall prognosis for SVT is good with the majority responding to transplacental therapy. In cases with congenital atrioventricular block, the outcome was less favourable, especially when the atrioventricular block was associated with congenital heart disease.

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“…Although most fetal ARRs are benign, some can cause fetal hydrops and lead to fetal death . This means that up to one fetus in 100 need their ARRs to be closely monitored and if indicated treated in utero using antiarrhythmic therapy . Thus, there is a clear motivation for elaborating a portable system, which enables the diagnosis and remote monitoring of the fetal heart.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive fetal electrocardiography for the detection of fetal arrhythmias

et al. 2019

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Objective To assess whether noninvasive fetal electrocardiography (NI‐FECG) enables the diagnosis of fetal arrhythmias. Methods A total of 500 echocardiography and NI‐FECG recordings were collected from pregnant women during a routine medical visit in this multicenter study. All the cases with fetal arrhythmias (n = 12) and a matching number of control (n = 14) were used. Two perinatal cardiologists analyzed the extracted NI‐FECG while blinded to the echocardiography. The NI‐FECG‐based diagnosis was compared with the reference fetal echocardiography diagnosis. Results NI‐FECG and fetal echocardiography agreed on all cases (Ac = 100%) on the presence of an arrhythmia or not. However, in one case, the type of arrhythmia identified by the NI‐FECG was incorrect because of the low resolution of the extracted fetal P‐wave, which prevented resolving the mechanism (2:1 atrioventricular conduction) of the atrial tachycardia. Conclusion It is possible to diagnose fetal arrhythmias using the NI‐FECG technique. However, this study identifies that improvement in algorithms for reconstructing the P‐wave is critical to systematically resolve the mechanisms underlying the arrhythmias. The elaboration of a NI‐FECG Holter device will offer new opportunities for fetal diagnosis and remote monitoring of problematic pregnancies because of its low‐cost, noninvasiveness, portability, and minimal setup requirements.

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Fetal arrhythmias: Natural history and management

Cited by 30 publications

References 32 publications

Hepatic venous Doppler in the evaluation of fetal extrasystoles

Hepatic venous Doppler in the evaluation of fetal extrasystoles

Prenatal Diagnosis, Management and Outcome of Fetal Dysrhythmia: A Tertiary Fetal Medicine Centre Experience over an Eight-Year Period

Noninvasive fetal electrocardiography for the detection of fetal arrhythmias

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