Intrauterine diagnosis and control of fetal ventricular arrhythmia during labor

Eibschitz, I; Abinader, Edward G.; Klein, Alan F.; Шарф, М

doi:10.1016/0002-9378(75)90056-3

Cited by 35 publications

(20 citation statements)

References 4 publications

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“…Although supraventricular extrasystoles are considered benign arrhythmias, it is still unclear what the cause of this disturbance is. Some authors have suggested that fetal extrasystoles are the result of elevated maternal epinephrine levels [20,21]. Others have suggested that supraventricular extrasystoles are a function of immaturity of the conductive tissue [22].…”

Section: Discussionmentioning

confidence: 99%

Spectral Analysis of Fetal Heart Rate Variability in Fetuses with Supraventricular Extrasystoles

Troeger

Schaub²,

Bernasconi³

et al. 2003

Fetal Diagn Ther

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Objective: Fetal heart rate (FHR) variability is an important indicator of fetal well-being. In fetal tachyarrhythmias, however, visual analysis of FHR variability is limited. We therefore applied power spectral analysis of FHR to evaluate the fetal state. Methods: Fetal R-R intervals were detected by means of an external ECG in 3 fetuses with supraventricular extrasystoles after cardiac malformations had been excluded by fetal echocardiography. Using an autoregressive model, power spectral densities were calculated from 20 consecutive 256-beat segments for the following frequency bands: <0.03 Hz (very low frequency), 0.03–0.069 Hz (low frequency; LF), 0.07–0.129 Hz (mid-frequency) and 0.13–1.0 Hz (high frequency; HF). Results: The FHR variability in fetal supraventricular extrasystoles mainly resulted from the HF component (63.91 ± 6.97%). The sympatho-vagal balance (LF/HF) was decreased in the tracings with extrasystoles (0.13). Conclusion: The analysis of FHR variability in fetal supraventricular extrasystoles revealed an imbalance between sympathetic and parasympathetic regulation.

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Section: Discussionmentioning

confidence: 99%

Spectral Analysis of Fetal Heart Rate Variability in Fetuses with Supraventricular Extrasystoles

Troeger

Schaub²,

Bernasconi³

et al. 2003

Fetal Diagn Ther

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“…Reports of ventricular tachycardia in neonates, also, indicate an association with congenital heart disease (Anthony et al, 1966;DeGuzman and Silver, 1970), metabolic abnormality-hyperkalaemia secondary to adrenogenital syndrome (Addy and Littlewood, 1969), and cardiac tumour (Van der Hauwaert, 1971). At least one idiopathic case has been reported (Hernandez et al, 1975), and in one the diagnosis was made in utero (Eibschitz et al, 1975). In our patient, all such conditions were ruled out by cardiac catheterisation and other laboratory tests.…”

Section: Discussionmentioning

confidence: 72%

“…Ventricular tachycardia is unusual in children and even rarer in neonates (Addy and Littlewood, 1969;DeGuzman and Silver, 1970;Eibschitz et al, 1975;Hernandez et al, 1975). Torsade de pointes, a variant of ventricular tachycardia, is also rare.…”

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confidence: 99%

Torsade de pointes ventricular tachycardia in a newborn infant.

Finley¹,

Radford²,

Freedom³

1978

Heart

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suMMARY A case of paroxysmal ventricular tachycardia of torsade de pointes variety occurring in a newborn infant is described. A rare problem in the newborn, ventricular tachycardia has been associated with congenital heart disease, electrolyte abnormality, and cardiac tumour. In this case, the association was with myocarditis. The arrhythmia was refractory to treatment, and the infant died.Ventricular tachycardia is unusual in children and even rarer in neonates (Addy and Littlewood, 1969;DeGuzman and Silver, 1970;Eibschitz et al., 1975;Hernandez et al., 1975). Torsade de pointes, a variant of ventricular tachycardia, is also rare. It is recognisable by a regularly changing axis in the ventricular complexes of the electrocardiogram (Krikler and Curry, 1976). We present here a case of paroxysmal ventricular tachycardia of torsade de pointes variety, which occurred in a newborn infant with myocarditis and caused a rare and difficult management problem. We are not aware of a report of a similar case. Case report A male infant was born of a 21-year-old primigravida after a normal pregnancy and with no exposure to known teratogens. Labour, which was induced at term by rupture of membranes, lasted 9 hours. Fetal heart rate was normal during labour. Birthweight was 341 kg, height 45 cm, and head circumference 35 cm. The infant appeared well at birth and had normal Apgar scores. About 4 hours later, he was noted to have an irregular heart rate and appeared dusky after a feeding. Signs of respiratory distress and a very abnormal electrocardiogram prompted transfer to The Hospital for Sick Children.On arrival here, at 6 hours of age, the infant was acyanotic, but lethargic. The pulse was irregular, and its rate varied from 50 to 200/min; the respiratory rate was 62/min, temperature was 37°C, blood pressure was 64 mmHg in both arms and 72 mmHg in both legs. Pulses were strong in all limbs except during tachycardia. The chest was clear and heart sounds were normal. A soft systolic ejection murmur was heard over the left sternal border. There was no cranial bruit. The liver edge was palpated 1 cm below the right costal margin.A radiograph showed distinct enlargement of the heart, normal pulmonary vascularity, and a left aortic arch. The electrocardiogram showed complete heart block with ventricular ectopic beats giving rise to paroxysms of ventricular tachycardia (Fig. 1, 2, and 3

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“…In spite of several cases treated successfully with flecainide, the choice of this drug is controversial because a fetal demise was reported [12], and the use of verapamil was not recommended because of its adverse effects on myocardial function in neonates with congestive heart failure [13]. Propranolol, a nonselective beta-adrenergic blocking agent, has not been used widely in cases of fetal tachycardia [14,15]. Propranolol has been applied for various indications such as maternal hyperthyroidism, maternal cardiac disease, and hypertension.…”

Section: Discussionmentioning

confidence: 99%

Fetal Atrial Tachycardia Diagnosed by Magnetocardiography and Direct Fetal Electrocardiography

Ishii¹,

Chiba²,

Sasaki³

et al. 2003

Fetal Diagn Ther

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At 26 weeks of gestation, fetal tachyarrhythmias (about 250 bpm) and ascites were detected by ultrasonography, and oral treatment with propranolol (30 mg/day) was commenced. Within 10 h, the fetal heart rate changed to approximately 85 bpm. The averaged fetal magnetocardiogram triggered by R peaks showed P wave and QRS complexes and an extra P wave. In addition, many extra nonconducted P-waves were detected in a fetal direct electrocardiogram. At 27 weeks of gestation, fetal tachycardia occurred again, and arrhythmia was diagnosed as the result of a blocked premature atrial contraction (PAC) with intermittent atrial tachycardia by fetal electrocardiogram. Administration of transplacental propranolol (90 mg/day) resolved the fetal tachyarrhythmias and ascites. Further studies are required to evaluate the efficacy and adverse effects of propranolol for fetal atrial tachycardia.

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Intrauterine diagnosis and control of fetal ventricular arrhythmia during labor

Cited by 35 publications

References 4 publications

Spectral Analysis of Fetal Heart Rate Variability in Fetuses with Supraventricular Extrasystoles

Spectral Analysis of Fetal Heart Rate Variability in Fetuses with Supraventricular Extrasystoles

Torsade de pointes ventricular tachycardia in a newborn infant.

Fetal Atrial Tachycardia Diagnosed by Magnetocardiography and Direct Fetal Electrocardiography

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