Abstract
The present study aimed to evaluate the management of fetal cardiac dysrhythmias based on prior identification of the underlying electrophysiological mechanism. We studied 36 consecutive fetuses with cardiac dysrhythmia. Rhythm diagnosis was based on M-mode, pulsed wave Doppler and tissue Doppler imaging (TDI). Only fetuses with: (i) incessant tachycardia (> 12 h) and mean ventricular rate > 200 beats/min, (ii) signs of left ventricular dysfunction, or (iii) hydrops, were treated using oral maternal drug therapy. The mean gestational age at diagnosis was 24.3 +/- 4.5 weeks. Twenty-one fetuses had tachycardia with a 1: 1 atrial-ventricular (AV) conduction. Based on ventricular-atrial interval, prenatal diagnosis was: permanent junctional reciprocating (n = 6), atrial ectopic (n = 6) or atrial-ventricular re-entry tachycardia (n = 9). One had atrial flutter, one ventricular tachycardia and four congenital AV block. Nine showed premature atrial or ventricular beats. Fifteen fetuses with incessant tachycardia, left ventricular dysfunction or hydrops were prenatally treated with maternal administration of digoxin, sotalol or flecainide. The total success rate (sinus rhythm or rate control) was 14/15 (93%). Seven fetuses were hydropi...Continue Reading
References
Nov 1, 1979·The Journal of Pediatrics·J W Newburger, J F Keane
Jan 1, 1978·Acta Obstetricia Et Gynecologica Scandinavica·N H Valerius, J R Jacobsen
Aug 1, 1988·The American Journal of Cardiology·V R ZalesD W Benson
Feb 1, 1985·Obstetrical & Gynecological Survey·M G BergmansH C Kock
May 1, 1985·Journal of Clinical Ultrasound : JCU·N H SilvermanM S Golbus
Nov 16, 1972·The New England Journal of Medicine·M C RogersT W Smith
Sep 1, 1983·British Heart Journal·L D AllanM Tynan
Nov 1, 1995·American Journal of Obstetrics and Gynecology·J A CopelC S Kleinman
May 1, 1995·Clinical Pharmacokinetics·R M Ward
Sep 22, 1994·The New England Journal of Medicine·D M Roden
May 1, 1993·American Heart Journal·U GembruchM Hansmann
Jun 1, 1996·Journal of the American College of Cardiology·Z J NaheedS S Gidding
Oct 1, 1996·Acta Paediatrica·S E SonessonM Westgren
Mar 17, 1999·Heart·J M Simpson, G K Sharland
Apr 14, 1999·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·R P SchadeE J Meijboom
Nov 11, 1999·Arthritis and Rheumatism·S SaleebJ P Buyon
Jun 14, 2000·Circulation·M A OudijkE J Meijboom
Sep 21, 2001·Neuroscience·R SmithJ P Walsh
Mar 15, 2002·Pediatric Cardiology·E S EbenrothR K Darragh
Oct 3, 2002·Circulation·A J J T ReinD J Sahn
Aug 23, 2003·Journal of the American College of Cardiology·Martijn A OudijkErik J Meijboom
Dec 10, 2003·Obstetrics and Gynecology·Talvikki BoldtSture Andersson
Sep 14, 2004·Pediatric Cardiology·C S Kleinman, R A Nehgme
Oct 7, 2004·American Journal of Obstetrics and Gynecology·Andrew H Van BergenNancy Davis
Citations
May 29, 2012·Pediatric Cardiology·Shreya MoodleyGeorge G S Sandor
Apr 27, 2010·Nature Reviews. Cardiology·Janette F Strasburger, Ronald T Wakai
Sep 11, 2008·Current Opinion in Pediatrics·Shardha Srinivasan, Janette Strasburger
Aug 24, 2017·Prenatal Diagnosis·Garick D HillMichele A Frommelt
Aug 20, 2009·Cardiology in the Young·Rajka Lulić JurjevićSamo Vesel
Nov 28, 2018·Pediatric Cardiology·Shi-Min Yuan
Jul 3, 2021·Journal of Clinical Medicine·Alina VedutaPaolo Cavoretto