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Electrophysiologic features of fetal ventricular aneurysms and diverticula. Prenat Diagn 2015 Feb;35(2):129-36

Date

10/07/2014

Pubmed ID

25284224

Pubmed Central ID

PMC4319987

DOI

10.1002/pd.4501

Scopus ID

2-s2.0-84922154024 (requires institutional sign-in at Scopus site)   14 Citations

Abstract

OBJECTIVE: Congenital ventricular wall defects are very rare and include congenital ventricular aneurysms (CVAs) and diverticula (CVDs).

METHOD: We report a series of five fetuses: three with CVAs and two with CVDs referred due to fetal arrhythmia. In addition to routine fetal echocardiography, fetal magnetocardiography (fMCG) was used. The literature in CVA and CVD is reviewed.

RESULTS: Incessant premature ventricular contractions (PVC), mainly bigeminy and trigeminy were found in three fetuses with CVAs and in one with CVD, who also had ventricular couplets. The other fetus with CVD, referred because of PVCs, had only sinus tachycardia. ST elevation was noted in two. Fetal movement had a variable impact on PVCs. Postnatal evaluation demonstrated two persistent left ventricular aneurysms and one persistent right CVD; one CVD resolved at 35-week gestation. Two neonates had incessant PVCs. Both arrhythmias resolved spontaneously while being treated with propranolol.

CONCLUSION: FMCG is complementary to echocardiographic imaging. In fetuses with left ventricular wall defects, additional electrophysiological diagnosis can be made by fMCG, including the complexity of ventricular ectopy, arrhythmic response to fetal movement, presence of ST-T wave abnormalities, and atrial amplitude increases. Prenatal risk factor assessment using fMCG can additionally support post-natal treatment and follow-up.

Author List

Peters C, Wacker-Gussmann A, Strasburger JF, Cuneo BF, Gotteiner NL, Gulecyuz M, Wakai RT

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

Diverticulum
Echocardiography
Female
Fetal Diseases
Fetal Heart
Heart Aneurysm
Humans
Infant, Newborn
Magnetocardiography
Pregnancy
Retrospective Studies