Fetal cardiac arrhythmia detection and in utero therapy. Nat Rev Cardiol 2010 May;7(5):277-90
Date
04/27/2010Pubmed ID
20418904Pubmed Central ID
PMC2995324DOI
10.1038/nrcardio.2010.32Scopus ID
2-s2.0-77951735572 (requires institutional sign-in at Scopus site) 114 CitationsAbstract
The human fetal heart develops arrhythmias and conduction disturbances in response to ischemia, inflammation, electrolyte disturbances, altered load states, structural defects, inherited genetic conditions, and many other causes. Yet sinus rhythm is present without altered rate or rhythm in some of the most serious electrophysiological diseases, which makes detection of diseases of the fetal conduction system challenging in the absence of magnetocardiographic or electrocardiographic recording techniques. Life-threatening changes in QRS or QT intervals can be completely unrecognized if heart rate is the only feature to be altered. For many fetal arrhythmias, echocardiography alone can assess important clinical parameters for diagnosis. Appropriate treatment of the fetus requires awareness of arrhythmia characteristics, mechanisms, and potential associations. Criteria to define fetal bradycardia specific to gestational age are now available and may allow detection of ion channelopathies, which are associated with fetal and neonatal bradycardia. Ectopic beats, once thought to be entirely benign, are now recognized to have important pathologic associations. Fetal tachyarrhythmias can now be defined precisely for mechanism-specific therapy and for subsequent monitoring of response. This article reviews the current and future diagnostic techniques and pharmacologic treatments for fetal arrhythmia.
Author List
Strasburger JF, Wakai RTAuthor
Janette F. Strasburger MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Arrhythmias, CardiacAtrioventricular Block
Bradycardia
Echocardiography, Doppler
Electrocardiography
Female
Fetal Diseases
Fetal Heart
Fetal Monitoring
Follow-Up Studies
Gestational Age
Heart Conduction System
Humans
Pregnancy
Prenatal Diagnosis
Risk Assessment
Survival Rate
Ultrasonography, Prenatal
