Long-term neurodevelopmental outcome after fetal arrhythmia

Area of Science:

• Fetal cardiology
• Pediatric neurology
• Developmental pediatrics

Background:

• Fetal cardiac arrhythmias, including tachyarrhythmias and bradyarrhythmias, can impact long-term neurodevelopmental outcomes.
• Understanding the prognosis associated with different types of fetal arrhythmias is crucial for appropriate management and counseling.

Purpose of the Study:

• To determine the long-term neurodevelopmental outcome in fetuses diagnosed with severe tachy- or bradyarrhythmia.
• To evaluate the neurological, mental, and psychomotor development in infants born with fetal cardiac arrhythmias.

Main Methods:

• A follow-up study design was employed to assess neurodevelopmental outcomes.
• Patients were categorized based on their specific fetal cardiac arrhythmia: supraventricular tachycardia (SVT), atrial flutter (AF), and atrioventricular block (AVB).
• Neurodevelopmental assessments included neurological, mental, and psychomotor evaluations.

Main Results:

• A total of 44 fetuses were diagnosed with tachy- or bradyarrhythmia (28 SVT, 7 AF, 9 AVB).
• Mortality rates were low for SVT (6%) and AF (6%), but high for AVB (78%).
• Neurodevelopmental outcomes were normal in survivors of SVT and AF, with one exception. Two of three AVB survivors experienced severe developmental delay.

Conclusions:

• Infants with fetal supraventricular tachycardia (SVT) and atrial flutter (AF) have a low risk of mortality and neurodevelopmental impairment.
• Infants with fetal atrioventricular block (AVB) face an elevated mortality rate and a significant risk of severe developmental delay.