Fetal Tachyarrhythmia - Part I: Diagnosis

Oudijk, Martijn A and Visser, Gerard HA and Meijboom, Erik J (2004) Fetal Tachyarrhythmia - Part I: Diagnosis. [Journal (Paginated)]

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Fetal tachycardia, first recognized in 1930 by Hyman et al1, is a condition occurring in approximately 0.4-0.6% of all pregnancies2. A subset of these cases with more sustained periods of tachycardia is clinically relevant. The necessity of therapeutic intervention in this condition is still a matter of discussion focused on the natural history of the disease. The spectrum of opinions varies from non-intervention3,4,5 based on a number of cases in which the tachycardia subsided spontaneously6, to aggressive pharmacotherapeutic intervention7,8 based on reports of deterioration of the fetal condition ultimately ending in significant neurological morbidity9,10,11, or fetal demise12,13,14. Prenatal treatment through indirect, maternally administered drug therapy seems to be the preference of most centers15,16,17,18,19,20,21. This matter will be discussed further in Fetal Tachyarrhythmia, Part II, Treatment.

Item Type:Journal (Paginated)
Keywords:Fetal tachyarhythmia; fetal echocardiography; fetal magnetocardiography
Subjects:JOURNALS > Indian Pacing and Electrophysiology Journal
ID Code:4191
Deposited By: Indian Pacing and Electrophysiology, Journal
Deposited On:13 Apr 2005
Last Modified:11 Mar 2011 08:55

References in Article

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1. Hyman AS. Irregularities of the fetal heart: a phonocardiographic study of the fetal heart sounds from the fifth to eighth months of pregnancy. Am J Obstet Gynecol 1930;20:332-347

2. Bergmans MGM, Jonker GJ, Kock HCL. Fetal supraventricular tachycardia: review of the literature. Obstet Gynecol Surv 1985;40:61-8

3. Simpson LL, Marx GR, D`Alton ME. Supraventricular tachycardia in the fetus: conservative management in the absence of hemodynamic compromise. J Ultrasound Med 1997;16:459-464

4. Gunteroth WG, Cyr DR, Shields LE, et al. Rate-based management of fetal supraventricular tachycardia. J Ultrasound Med 1996;15:453-458

5. Cuneo BF, Strasburger JF. Management strategy for fetal tachycardia. Obstet Gynecol 2000;96:575-81

6. Wladimiroff JW, Stewart PA. Treatment of fetal cardiac arrhythmias. Br J Hosp Med 1985: 134-140

7. Hansmann M, Gembruch U, Bald R, et al. Fetal tachyarrhythmias: transplacental and direct treatment of the fetus. A report of 60 cases. Ultrasound Obstet Gynecol 1991;1:162-170

8. Kohl T, Tercanli S, Kececioglu D, et al. Direct fetal administration of adenosine for the termination of incessant supraventricular tachycardia. Obstet Gynecol 1995;85:873-874

9. Schade RP, Stoutenbeek Ph, de Vries LS, et al. Neurological morbidity after fetal supraventricular tachyarrhythmia. Ultrasound Obstet Gynecol 1999;13:43-47

10. Sonesson SE, Winberg P, Lidegran M, Westgren M. Foetal supraventricular tachycardia and cerebral complications. Acta Paediatr 1996;85:1249-52

11. Donn SM, Bowerman RA. Association of paroxysmal supraventricular tachycardia and periventricular leukomalacia. Am J Perinatol 1993;10:212-14

12. Strasburger JF. Fetal arrhythmias. Prog Pediatr Cardiol 2000;11(1):1-17

13. Allan LD, Anderson RH, Sullivan ID, et al. Evaluation of fetal arrhythmias by echocardiography. Br Heart J 1983;50:240-245

14. Kleinman CS, Copel JA, Weinstein EM, et al. Treatment of fetal supraventricular tachyarrhythmias. J Clin Ultrasound 1985;13:265-273

15. Allan LD, Chita SK, Sharland GK, et al. Flecainide in the treatment of fetal tachycardias. Br Heart J 1991;65:46-8

16. Copel JA, Friedman AH, Kleinman CS. Management of fetal cardiac arrhythmias. Fetal Diagn Ther 1997;24:201-211

17. Krapp M, Baschat AA, Gembruch U, Geipel A, Germer U. Flecainide in the intrauterine treatment of fetal supraventricular tachycardia. Ultrasound Obstet Gynecol 2002;19:158-164

18. Van Engelen AD, Weijtens O, Brenner JI, et al. Management, outcome and follow-up of fetal tachycardia. J Am Coll Cardiol 1994;24:1371-5

19. Frohn-Mulder IM, Stewart PA, Witsenburg M, et al. The efficacy of flecainide versus digoxin in the management of fetal supraventricular tachycardia. Pren Diagn 1995;15:1297-1302

20. Oudijk MA, Ruskamp JM, Ambachtsheer EB, et al. Drug treatment of fetal tachycardias. Pediatr Drugs 2002;4(1):49-63

21. Oudijk MA, Michon MM, Kleinman CS, et al. Sotalol in the treatment of fetal dysrhythmias. Circulation 200;101:2721-2726

22. Kleinman CS, Nehgme R, Copel JA, et al. Fetal cardiac arrhythmias: diagnosis and therapy. In: Creasy RK, Resnik R, editors. Matern-fetal medicine. Philadelphia (PA): Saunders, 1998:301-318

23. Jaeggi E, Fouron JC, Fournier A, van Doesburg N, Drblik SP, Proulx F. Ventriculo-atrial time interval measured on M-mode echocardiography: a determining element in diagnosis, treatment and prognosis of fetal supraventricular tachycardia. Heart 1998;79:582-587

24. Oudijk MA, Stoutenbeek Ph, Sreeram N, Visser GHA, Meijboom EJ. Persistent junctional reciprocating tachycardia in the fetus. J Matern Fetal Neonatal Med 2003;13(3):191-6

25. Fouron JC, Proulx F, MirĂ³ J, Gosselin J. Doppler and M-mode ultrasonography to time fetal atrial and ventricular contractions. Obstet Gynecol 2000;96:732-6

26. Fouron JC, Fournier A, Proulx F, Lamarche J, Bigras JL, Boutin, Brassard M, Gamache S. Management of fetal tachyarrhythmia based on superior vena cava/aorta Doppler flow recordings. Heart 2003;89:1211-1216

27. Quartero HWP, Stinstra JG, Golbach EGM, Meijboom EJ, Peters MJ. Clinical implications of fetal magnetocardiography. Ultrasound Obstet Gynecol 2002;20(2):142-53

28. Rooth, G, Huch A, Huch R. Guidelines for the use of fetal monitoring. Int J Gynecol Obstet 1987;25:159

29. Nijhuis IJM, Hof J ten, Mulder EJH, et al. Antenatal fetal heart rate monitoring; normograms and minimal duration of recordings. Prenat Neonat Med 1998;3:314-22

30. Grimm B, Haueisen J, Huotilainen M, Lange S, van Leeuwen P, Menedez T, Peters MJ, Schleussner E, Schneider U. Recommended standards for fetal magnetocardiography. Pacing Clin Electrophysiol 2003;26(11):2121-6

31. Jaeggi E, Fouron JC, Drblik SP. Fetal atrial flutter: diagnosis clinical features, treatment and outcome. J Pediatr 1998;132:335-339

32. Lisowski LA, Verheijen PM, Benatar AA, et al. Atrial flutter in the perinatal age group: diagnosis, management and outcome. J Am Coll Cardiol 2000;35:771-7

33. Simpson JM, Sharland GK. Fetal tachycardias: management and outcome of 127 consecutive cases. Heart 1998;79:576-581

34. Ko JK, Deal BJ, Strasburger JF, Benson DW Jr. Supraventricular tachycardia mechanisms and their age distribution in pediatric patients. Am J Cardiol 1992;69(12):1028-32

35. Villazon E, Fouron JC, Fournier A, Proulx F. Prenatal diagnosis of junctional ectopic tachycardia. Pediatr Cardiol 2001;22:160-162

36. Hosono T, Chiba Y, Shinto M, Kandori A, Tsukada. A fetal Wolff-Parkinson-White syndrome diagnosed prenatally by magnetocardiography. Fetal Diagn Ther 2001;16:215-217

37. Menendez T, Achenbach S, Beinder, et al. Usefulness of magnetocardiography for the investigation of fetal arrhythmias. Am J cardiol 2001;88:334-336

38. Schwartz PJ, Stramba-Badiale M, Segantini A, et al. Prolongation of the QT interval and the Sudden Infant Death Syndrome. N Engl J Med 1998;338:1709-14

39. Garson A, Dick M, Fournier A, et al. The long QT syndrome in children. Circulation 1993;87:1866-1872

40. Hamada H, Horigome H, Asaka M, et al. Prenatal diagnosis of long QT syndrome using fetal magnetocardiography. Prenat Diagn 1999;19:677-680

41. Cuneo BF, Ovadia M, Strasburger JF, Zhao H, Petropulos T, Schneider J, Wakai RT. Prenatal diagnosis and in utero treatment of torsades de pointes associated with congenital long QT syndrome. Am J Cardiol 2003;91(11): 1395-8


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