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Fetal arrhythmias

E J Meijboom1, A D van Engelen, E W van de Beek

  • 1Wilhelmina Children's Hospital, University of Utrecht, The Netherlands.

Current Opinion in Cardiology
|January 1, 1994
PubMed
Summary
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Fetal arrhythmias, including tachycardias and bradycardias, can be identified and treated prenatally using maternal medication. Fetal hydrops indicates arrhythmia severity, and some conditions like atrioventricular block may require postpartum treatment.

Area of Science:

  • Cardiology
  • Obstetrics
  • Fetal Medicine

Background:

  • Fetal arrhythmias are increasingly recognized, with fetal hydrops linked to arrhythmia severity.
  • Sophisticated fetal echocardiography aids in diagnosing and managing fetal arrhythmias.

Purpose of the Study:

  • To review the identification and treatment of fetal tachycardias and bradycardias.
  • To discuss the role of maternal antiarrhythmic medication and postpartum management.

Main Methods:

  • Review of diagnostic techniques including fetal echocardiography.
  • Analysis of therapeutic approaches for fetal arrhythmias, including maternal oral medication.
  • Discussion of the pathophysiology of fetal atrioventricular block.

Main Results:

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  • Fetal tachycardias (sinus, supraventricular, atrial flutter/fibrillation, ventricular) can be diagnosed early and treated effectively with maternal oral antiarrhythmic drugs.
  • Commonly used drugs include digoxin, flecainide, amiodarone, and sotalol.
  • Fetal bradycardias include sinus bradycardia and atrioventricular block, with isolated atrioventricular block linked to maternal SS-A/SS-B autoantibodies causing inflammatory node disease.

Conclusions:

  • Prenatal treatment of fetal arrhythmias is effective, with oral maternal medication being a safe and convenient option.
  • Postpartum treatment may be necessary for relapsing tachycardias.
  • Isolated fetal atrioventricular block results from maternal autoantibodies causing inflammatory damage to the fetal atrioventricular node.