Blocked Atrial Bi/Trigeminy In Utero Evolving in Supraventricular Tachycardia after Birth

Martucci, Vanessa; Cerekja, Albana; Caiaro, Angela; Bosco, Giovanna; Lucchini, Renato; Piacentini, Gerardo; Marino, Benedetto; Ventriglia, Flavia

doi:10.1155/2012/406497

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…It was present in only 1 subject (10%), but this corroborates that fetuses with PACs are at risk of developing SVT. 9,12 Martucci et al 17 reported a case study in which the subject was referred with BAB that developed SVT after birth. The subjects with AVB showed fewer other rhythms.…”

Section: Discussionmentioning

confidence: 99%

Magnetophysiologic and echocardiographic comparison of blocked atrial bigeminy and 2:1 atrioventricular block in the fetus

et al. 2013

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BACKGROUND Blocked atrial bigeminy (BAB) and second-degree atrioventricular block with 2:1 conduction block (2:1 AVB) both present as ventricular bradycardia and can be difficult to distinguish by echocardiography. Since the prognosis and clinical management of these rhythms are different, an accurate diagnosis is essential. OBJECTIVE To identify magnetic and mechanical heart rate and rhythm parameters that could reliably distinguish BAB from 2:1 AVB. METHODS A retrospective fetal magnetocardiography (fMCG) and pulsed Doppler ultrasound study of 10 subjects with BAB and 7 subjects with 2:1 AVB was performed in order to identify parameters that could reliably distinguish BAB from 2:1 AVB. RESULTS Distinguishing BAB from 2:1 AVB by using fMCG was relatively straightforward because in BAB the ectopic P wave (P′) occurred early, resulting in a bigeminal (short-long) atrial rhythm. The normalized coupling interval of the ectopic beat (PP′ of the blocked beat to PP of the conducted beat) was 0.29 ± 0.03. In contrast, the echocardiographic assessment of inflow-outflow gave a normalized mechanical coupling interval (AA′/AA) near 0.5, which made it difficult to distinguish BAB from 2:1 AVB. Heart rate distinguished most subjects with BAB from those with 2:1 AVB (82 ± 5.7 beats/min vs 69 ± 4.2 beats/min), but was not a completely reliable indicator. In most subjects, BAB alternated with sinus rhythm or other rhythms, resulting in complex heart rate and rhythm patterns. CONCLUSIONS Fetal BAB and 2:1 AV block can be difficult to distinguish using echocardiography because in many fetuses with BAB the mechanical rhythm does not accurately reflect the magnetic rhythm. fMCG provides a more reliable means of making a differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

Magnetophysiologic and echocardiographic comparison of blocked atrial bigeminy and 2:1 atrioventricular block in the fetus

et al. 2013

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“…Their case also showed a normal rhythm immediately after delivery; however, contrary to our case, trigeminal PACs and supraventricular tachycardia (SVT) developed 11 days after birth [9]. …”

Section: Discussionmentioning

confidence: 65%

“…Martucci et al reported a fetus with pseudobradycardia due to trigeminal PACs on the 33rd week of gestation. Their case also showed a normal rhythm immediately after delivery; however, contrary to our case, trigeminal PACs and supraventricular tachycardia (SVT) developed 11 days after birth [ 9 ].…”

Section: Discussionmentioning

confidence: 65%

Importance of Close Follow-Up in the Fetus with Premature Atrial Contractions Accompanied by Atrial Septal Aneurysm: A Case Report

Yozgat

Kilic

Karadeniz

et al. 2013

Case Reports in Obstetrics and Gynecology

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Rhythms that derive from parts of atria other than the sinus node are called premature atrial contractions (PACs). Vast majority of fetal PACs are idiopathic. Fetal PACs usually have a good prognosis and disappear spontaneously during pregnancy or after delivery. Development of fetal tachycardia or fetal bradycardia is rarely reported during follow-up of fetuses diagnosed with PACs. To the best of our knowledge, coexistence of tachycardia and bradycardia leading to hemodynamic impairment has not yet been reported. We present a fetus diagnosed with PACs and atrial septal aneurysm (ASA) on the 23rd week of gestation proceeding to fetal bradycardia and fetal tachycardia and consequently hemodynamic impairment. We suggest closer follow-up of fetuses with PACs accompanied by ASA.

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“…Our findings suggest that ASA-associated AF abates with resolution of the ASA in extra-uterine adaptation. Notably, Martucci et al [ 35 ] reported a fetus with pseudobradycardia caused by trigeminal PACs at week 33 of pregnancy. Their case also showed a normal rhythm immediately after birth.…”

Section: Discussionmentioning

confidence: 99%

Fetal Atrial Flutter Associated with Atrial Septal Aneurysm

et al. 2022

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Objective: To provide evidence that fetal atrial flutter (AF) caused by atrial septal aneurysm (ASA) can be completely cured by delivery. Methods: Cases series of three fetuses with ASA complicated by AF in late gestation, including hydrops fetalis in one case, were collected and completely followed up. Results: AF in all cases completely disappeared shortly after birth. New insights gained from this study are as follows: (1) PACs or bigeminy associated with ASA can progressively change to AF. (2) AF associated with ASA can cause hydrops fetalis and intrauterine treatment is needed; however, delivery is the definitive treatment. (3) AF associated with ASA completely resolves after birth. This is probably associated with changes in the circulation after birth, with no more blood flow crossing the foramen ovale and no turbulent flow in the ASA with reversal to hit the right atrial wall, activating ectopic pacemakers. Conclusions: This report may have clinical impact because it provides evidence that (1) in case of AF associated with ASA, the prognosis is much better than other causes and delivery should be strongly considered. (2) Fetuses diagnosed with AF should always be checked for the presence of ASA. (3) PAC/bigeminy related to ASA, different from isolated PAC, needs close follow-up for the development of SVT and AF. (4) Fetuses remote from term can benefit from intrauterine treatment to avoid hydrops fetalis, and to prolong gestation for maturity, early delivery is recommended once lung maturity is confirmed.

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Blocked Atrial Bi/Trigeminy In Utero Evolving in Supraventricular Tachycardia after Birth

Cited by 3 publications

References 6 publications

Magnetophysiologic and echocardiographic comparison of blocked atrial bigeminy and 2:1 atrioventricular block in the fetus

Magnetophysiologic and echocardiographic comparison of blocked atrial bigeminy and 2:1 atrioventricular block in the fetus

Importance of Close Follow-Up in the Fetus with Premature Atrial Contractions Accompanied by Atrial Septal Aneurysm: A Case Report

Fetal Atrial Flutter Associated with Atrial Septal Aneurysm

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