Faculty Collaboration Database

Location of accessory connection in infants presenting with supraventricular tachycardia in utero: clinical correlations. Am J Perinatol 2003 Apr;20(3):115-9

Date

06/13/2003

Pubmed ID

12802710

DOI

10.1055/s-2003-40014

Scopus ID

2-s2.0-0038315113 (requires institutional sign-in at Scopus site)   16 Citations

Abstract

The most common mechanism of fetal tachycardia is orthodromic reciprocating tachycardia utilizing an accessory atrioventricular connection, however, data regarding accessory connection location in patients with fetal tachycardia is limited. To investigate the location of accessory connections in fetal tachycardia, postnatal transesophageal electrophysiology studies were performed at one institution over a 10-year period in 24 infants with documented fetal tachycardia. The 18 infants with inducible orthodromic reciprocating tachycardia were grouped according to accessory connection location, and groups were compared regarding prenatal presentation and clinical course. Left-sided connections were found in 13 (72%) patients, while accessory connection location could not be determined in the remaining 5 (28%) patients. The presence of a left-sided accessory connection was associated with sustained tachycardia, depressed ventricular function, and the need for antiarrhythmic therapy in utero. No other difference in clinical or electrophysiologic data was found between groups. Our findings indicate that a high proportion of patients with fetal tachycardia have left-sided accessory connections, and a left-sided connection may adversely affect fetal hemodynamics and cardiac output.

Author List

Kannankeril PJ, Gotteiner NL, Deal BJ, Johnsrude CL, Strasburger JF

Author

Janette F. Strasburger MD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Bundle-Branch Block
Electrophysiologic Techniques, Cardiac
Female
Fetal Diseases
Gestational Age
Heart Conduction System
Humans
Infant, Newborn
Pre-Excitation Syndromes
Pregnancy
Prenatal Diagnosis
Tachycardia, Supraventricular