Prospective echocardiographic evaluation of atrioventricular conduction in fetuses with maternal Sjögren's antibodies

Bergen, Andrew H. Van; Cuneo, Bettina F.; Davis, Nancy

doi:10.1016/j.ajog.2004.06.047

Cited by 39 publications

(30 citation statements)

References 17 publications

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“…Treating this group may incur greater benefi t than risk. Since the incidence of incomplete AV block in fetuses with irregular rhythm in this series is greater than that of incomplete AV block in fetuses prospectively evaluated with maternal anti-Ro/anti-La antibodies [19,20] , we believe that detailed evaluation of AV conduction, including mechanical PR interval measurements, should be part of the routine evaluation of irregular fetal cardiac rhythm.…”

Section: Discussionmentioning

confidence: 91%

Conduction System Disease in Fetuses Evaluated for Irregular Cardiac Rhythm

et al. 2006

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Objectives: To determine the prevalence of 1st and 2nd degree AV block in fetuses with an irregular cardiac rhythm, and to summarize outcome of these pregnancies. Background: The diagnosis of irregular cardiac rhythm or ‘skipped beats’ includes isolated ectopy that resolves spontaneously. Recently, Doppler measurements of the ‘mechanical’ PR interval have been shown to identify AV conduction disease prenatally. Prenatal therapy of these conduction abnormalities may limit the progression to more advanced disease either in utero or after birth. Methods: A retrospective review was performed of fetuses evaluated between 1996 and 2004 with the findings of irregular cardiac rhythm. 1st or 2nd degree AV block was diagnosed on Doppler and M-mode recordings, and confirmed using either fetal magnetocardiography (fMCG) or postnatal 12-lead ECG. Dexamethasone was administered to 4 mothers with abnormal fetal AV conduction in the setting of anti-Ro/anti-La antibodies. Results: Of 702 fetuses initially referred for arrhythmia, 306 had an irregular rhythm. Eight (2.6%) had intermittent 1st or 2nd degree AV block confirmed by fMCG and/or postnatal 12-lead ECG. AV block was presumed idiopathic in 2, associated with congenital long QT syndrome in 2 or with clinically unsuspected maternal anti-Ro or anti-La antibodies in 4. During the intrauterine period there was no progression to complete AV block and all were born alive at 34–40 weeks of gestation. Conclusion: A small but clinically significant population of fetuses with irregular rhythm will have 1st or 2nd degree AV block. Transplacental therapy may limit the intrauterine progression to more advanced disease.

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Section: Discussionmentioning

confidence: 91%

Conduction System Disease in Fetuses Evaluated for Irregular Cardiac Rhythm

et al. 2006

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“…Des études expérimentales [36] et cliniques [37] ont montré la supériorité du Doppler pour mesurer l'intervalle AV (temps de conduction auriculoventriculaire considéré comme l'équivalent fonctionnel [38] de l'intervalle PR électrocardiographique) et permettre le diagnostic de BAV I. Deux méthodes sont classiquement décrites pour sa mesure en Doppler [39,40] :…”

Section: Techniques éChographiques Et Doppler D'étude Des Blocs Auricunclassified

“…Les critères diagnostiques des BAV sont les suivants : en présence d'anticorps anti-SS-A et/ou SS-B, quel que soit l'âge gestationnel, un intervalle AV > 150 ms en étude Doppler de la chambre du VG est évocateur d'un BAV I [38]. Jaeggi et al [44] définissent le BAV I par un intervalle AV > 140 ms avec l'incidence visualisant la veine cave supérieure et l'aorte ascendante ; il existe deux types de BAV II : le type Mobitz 1 caractérisé par un allongement progressif de l'intervalle AV au cours des cycles jusqu'à ce que la stimulation auriculaire ne soit plus conduite au ventricule, [45][46][47]) et un groupe témoin [48].…”

Section: Techniques éChographiques Et Doppler D'étude Des Blocs Auricunclassified

Échographie et Doppler fœtaux dans le bloc auriculoventriculaire congénital d’origine immunologique

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Houfflin‐Debarge

Richard

et al. 2009

Gynécologie Obstétrique & Fertilité

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“…AV block may be observed in the presence of structural heart disease (e.g., left atrial isomerism or polysplenia syndrome and lesions associated with L-ventricular looping; see Videoclip 42.9) [75,76] or in isolation, the latter of which is largely due to the influence of the maternal autoantibodies anti-Ro and anti-La [75,77]. With the development of normal AV time intervals in fetuses from 17 weeks to term using both pulsed-wave and tissue Doppler techniques [78,79], even first-degree AV block can be diagnosed prenatally.…”

Section: Ramentioning

confidence: 99%

Fetal Echocardiography

Hornberger

2009

Echocardiography in Pediatric and Congenital Heart Disease

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Prospective echocardiographic evaluation of atrioventricular conduction in fetuses with maternal Sjögren's antibodies

Cited by 39 publications

References 17 publications

Conduction System Disease in Fetuses Evaluated for Irregular Cardiac Rhythm

Conduction System Disease in Fetuses Evaluated for Irregular Cardiac Rhythm

Échographie et Doppler fœtaux dans le bloc auriculoventriculaire congénital d’origine immunologique

Fetal Echocardiography

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