Fetal cardiovascular dynamics during cardiac dysrhythmia. Case report

Wladimiroff, J. W.; Struyk, P.C.; Stewart, Patricia A.; Clusters, P.; Villeneuve, V. H. de

doi:10.1111/j.1471-0528.1983.tb08971.x

Cited by 14 publications

(2 citation statements)

References 10 publications

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“…Although the fetal abdominal electrocardiogram (ECG) has been available since 1906 (4), it provides :no information as to the haemodynamic consequences of arrhythmia. Mmode ultrasound technique (5) made it possible to study the dynamics of the human fetal heart, and it has been applied in cases of fetal heart arrhythmia by Wladimiroff et al (6). The combined real-time and pulsed Doppler technique introduced by Eik-Nes et al (7) provides important additional information concerning the type of arrhythmia and its circulatory effects (8,9).…”

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confidence: 99%

Clinical Outcome and Circulatory Effects of Fetal Cardiac Arrhythmia

1986

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ABSTRACT. By means of abdominal fetal ECG and non‐invasive ultrasound blood flow studies 113 cases of fetal cardiac arrhythmia were classified according to the origin of arrhythmia. Pregnancy outcome was characterized by an increased frequency of fetal distress and heart malformation, and increased fetal and neonatal mortality. The following types of arrhythmia were identified: supraventricular extrasystoles (n=84), paroxysmal tachycardia (n=6), sinus bradycardia (n=3), atrial flutter (n=1), ventricular extrasystolw (n=14), and atrioventricular block (n=5). In 37 cases the combined Doppler and real‐time ultrasound tehnique was used to measure fetal aortic blood flow as a means of studying the circulatory effects of the arrhythmia. Increased peak velocity, risiig slope and acceleration were found in the first post‐pausal beat after a supraventricular extrasystole or a missed beat; this supports the validity of Frank‐Starling law for the fetal heart and suggests that a strong relationship exists between these variables and myocardial contractility, In two cases of intra‐uterine heart failure, the effect of digoxin treatment in utero on the fetal aortic flow variables was studied, results indicating a positive inotropic effect of the drug on the fetal myocardium. The estimation of fetal aortic volume blood flow in cases of fetal cardiac arrhythmia is useful for early detection of fetal cardiac failure, and for monitoring the effects of intra‐uterine treatment.

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Clinical Outcome and Circulatory Effects of Fetal Cardiac Arrhythmia

1986

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“…[5][6][7][8] This study emphasises the importance of careful structural and rhythm analysis of the fetal heart when a cardiac arrhythmia has been established.…”

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confidence: 99%

Arrhythmia and structural abnormalities of the fetal heart.

Stewart¹,

Tonge²,

Wladimiroff³

1983

Heart

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suMMARY Thirty fetuses with cardiac arrythmias were referred for ultrasonography. This included cross sectional and M mode echocardiography and pulsed Doppler analysis of the fetal heart. Three types of arrhythmias were observed: ectopic beats, tachyarrhythmias, and bradycardia. Ectopic beats were associated with cardiac structural abnormalities in two cases, resulting in fetal death in one. Tachycardia was not associated with structural defect, but death from cardiac failure occurred in one patient. Transplacental treatment for tachyarrhythmia was not successful in our experience. In the group with bradycardia four cases had congenital cardiac abnormalities and the mortality rate was 50%.When a fetal cardiac arrhythmia has been established careful structural and rhythm analysis is of vital importance in facilitating prognosis, planning of time and mode of delivery, and monitoring of transplacental treatment where indicated.

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