Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-27T23:49:24.180Z Has data issue: false hasContentIssue false
  • English
  • Français

Irregular heart rate in the fetus—not always benign

Published online by Cambridge University Press:  19 August 2008

John M. Simpson ,
Robert W. Yates  and
Gurleen K. Sharland
John M. Simpson*
Affiliation:
From the Department of Fetal Cardiology, Guy's Hospital, London
Robert W. Yates
Affiliation:
From the Department of Fetal Cardiology, Guy's Hospital, London
Gurleen K. Sharland
Affiliation:
From the Department of Fetal Cardiology, Guy's Hospital, London
*
Dr. J.M. Simpson, Research Fellow in Fetal and Paediatric Cardiology, Department of Fetal Cardiology, 15th Floor, Guy's Hospital, London SE1 9RT, United Kingdom. Tel. 44-171 407 3351; Fax. 44-171 955 2637.
Get access Rights & Permissions [Opens in a new window]

Summary

One hundred-ninety-four fetuses with irregular heart rates were seen over a five-year period at a tertiary center for fetal cardiology. The median gestation at referral was 31 weeks, with a range from 19 to 41 weeks. Of these fetuses, 157 had extrasystoles of either atrial or ventricular origin. Blocked atrial ectopic beats had led to slow ventricular rates (80–110 beats per minute) in 37 fetuses. The structure of the heart was normal in all except two fetuses. Postnatal outcome was known for 165 of the fetuses. Of these, 157 (95%) had an uneventful antenatal and postnatal course. Tachyarrhythmias developed in eight fetuses (5%) in either the prenatal (n=4) or postnatal (n=4) period. Five of 37 fetuses with blocked atrial ectopic beats (13%) developed a tachyarrhythmia. No fetus developed hydrops, and all infants survived. All cases had required treatment with antiarrhythmic drugs. The occurrence of an irregular heart rhythm in the fetus, therefore, is not always benign. Fetuses with blocked atrial ectopic beats require particularly close monitoring.

Keywords

Fetusfetal heart arrhythmia
Type
Original Manuscripts
Information
Cardiology in the Young , Volume 6 , Issue 1 , January 1996 , pp. 28 - 31
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Allan, LD, Crawford, DC, Chita, SK, Tynan, MJ. Prenatal screening for congenital heart disease. Br Med J 1986; 292: 1717–1719.CrossRefGoogle ScholarPubMed
2. Shenker, L. Fetal cardiac arrhythmias. Obstet Gynecol Survey 1979; 34: 561–572.CrossRefGoogle ScholarPubMed
3. Komaromy, B, Gaal, J, Mihaly, G, Mocsary, P, Pohanka, O, Suranyi, S. Data on the significance of fetal arrhythmia. Am J ObsGyn 1967: 99:79–85.CrossRefGoogle ScholarPubMed
4. Komaromy, B, Gaal, J, Lampe, L. Fetal arrhythmia during pregnancy and labour. Br J Obs Gyn 1977; 84: 492–496.CrossRefGoogle ScholarPubMed
5. Allan, L, Anderson, R, Sullivan, I, Campbell, S, Holt, D, Tynan, M]. Evaluation of fetal arrhythmias by echocardiography. Br Heart J 1983; 50: 240–245.CrossRefGoogle ScholarPubMed
6. Maragnes, P, Fournier, A, Lessard, M, Fouron, JC. Evaluation et prognostic des arythmies foetales. Pediatrie 1991; 46: 481–488.Google Scholar
7. Ishihara, Y, Kanzaki, T, Kobayashi, H, Chiba, Y. Non-complicated fetal arrhythmias: prenatal diagnosis and follow-up study with Doppler blood flow analysis. Proceedings of 2nd World Congress of Perinatal Medicine,Rome,1993, pp 88–89. [Abstract]Google Scholar
8. Allan, LD. Arrhythmias. In: Manual of Fetal Echocardiogra phy. MTP Press Limited, Boston, 1986, p 162.Google Scholar
9. Kleinman, C, Donnerstein, R, Jaffe, C, DeVore, G, Weinstein, EM, Lynch, DC, Talner, NS, Berkowitz, RL, Hobbins, JC. Fetal echocardiography. A tool for evaluation of in utero cardiac arrhythmias and monitoring of in utero therapy: analysis of 71 patients. Am J Cardiol 1983; 51: 237–243.CrossRefGoogle Scholar
10. Silverman, NH. Prenatal recognition of cardiac abnormalities. In: Pediatrie Echocardiography. Willliams and Wilkins Publishing, London, 1993, pp 586–593.Google Scholar
11. Ferrer, PL, Gelband, H. Are fetal supraventricular extrasystoles always benign? Cardiol Young 1994; 4: 201.Google Scholar
12. Klapholz, H, Schifrin, BS, Rivo, E. Paroxysmal supraventricular tachycardia in the fetus. Obstet Gynecol 1974; 43: 718–721.Google ScholarPubMed
13. Allan, LD. Arrhythmias. In: Manual of Fetal Echocardiography. MTP Press Limited, Boston, 1986, pp 156–157.Google Scholar
14. Southall, D, Richards, J, Hardwick, R, Shinebourne, EA, Gibbens, GLD, Thelwall-Jones, H, De Swiet, M, Johnston, PGB. Pro spective study of fetal heart rate and rhythm patterns. Arch Dis Child 1980; 55: 506–511.CrossRefGoogle Scholar
15. Hansmann, M, Gembruch, R, Bald, R, Manz, M and Redel, DA. Fetal tachyarrhythmias: transplacental and direct treatment of the fetus—a report of 60 cases. Ultrasound Obstet Gynecol 1991; 1: 162–170.CrossRefGoogle ScholarPubMed
16. Moe, GK, Mendez, C. Physiological basis of premature beats and sustained tachycardias. N Eng J Med 1973; 288: 250–254.CrossRefGoogle ScholarPubMed
17. Zales, VR, Dunnigan, A, Benson, WD. Clinical and electro-physiological features of fetal and neonatal paroxysmal tachycardia resulting in congestive heart failure. Am J Cardiol 1988; 62: 225–228.CrossRefGoogle Scholar
18. Sung, RJ, Ferrer, P, Garcia, OL, Castellanos, A, Gelband, H. Atrioventricular reciprocal rhythm and chronic reciprocating tachycardia in a newborn infant concealed Wolff-Parkinson-White syndrome. Br Heart J 1977; 39: 810–814.CrossRefGoogle Scholar
19. Silver, W, Joos, HA, Lamazor, E, Nussbaum, A. Prodromal arrhythmias preceding the onset of paroxysmal supraventricular tachycardia in a newborn. Pediatrics 1973; 52: 871–872.CrossRefGoogle ScholarPubMed