Fetal Atrial Tachycardia Diagnosed by Magnetocardiography and Direct Fetal Electrocardiography

At 26 weeks of gestation, fetal tachyarrhythmias (about 250 bpm) and ascites were detected by ultrasonography, and oral treatment with propranolol (30 mg/day) was commenced. Within 10 h, the fetal heart rate changed to approximately 85 bpm. The averaged fetal magnetocardiogram triggered by R peaks showed P wave and QRS complexes and an extra P wave. In addition, many extra nonconducted P-waves were detected in a fetal direct electrocardiogram. At 27 weeks of gestation, fetal tachycardia occurred again, and arrhythmia was diagnosed as the result of a blocked premature atrial contraction (PAC) with intermittent atrial tachycardia by fetal electrocardiogram. Administration of transplacental propranolol (90 mg/day) resolved the fetal tachyarrhythmias and ascites. Further studies are required to evaluate the efficacy and adverse effects of propranolol for fetal atrial tachycardia.

[1]  S. Gidding,et al.  Fetal tachycardia: mechanisms and predictors of hydrops fetalis. , 1996, Journal of the American College of Cardiology.

[2]  W. Frishman,et al.  Beta-adrenergic blockers in pregnancy. , 1988, American heart journal.

[3]  E. Bossi,et al.  Effect of propranolol on fetal tachycardia in diabetic pregnancy. , 1978, The American journal of cardiology.

[4]  T. Hosono,et al.  A Case of Fetal Complete Heart Block Recorded by Magnetocardiography, Ultrasonography and Direct Fetal Electrocardiography , 2000, Fetal Diagnosis and Therapy.

[5]  M. Sharf,et al.  Intrauterine diagnosis and control of fetal ventricular arrhythmia during labor. , 1975, American journal of obstetrics and gynecology.

[6]  J. Strasburger,et al.  Fetal Supraventricular Tachycardia Complicated by Hydrops Fetalis: A Role for Direct Fetal Intramuscular Therapy , 1996, American journal of perinatology.

[7]  J. Brenner,et al.  Management outcome and follow-up of fetal tachycardia. , 1994, Journal of the American College of Cardiology.

[8]  A. Garson,et al.  Medicolegal problems in the management of cardiac arrhythmias in children. , 1987, Pediatrics.

[9]  M. Ovadia,et al.  Natural history of hydrops resolution in fetuses with tachyarrhythmias diagnosed and treated in utero. , 1996, Fetal diagnosis and therapy.

[10]  L. D. de Vries,et al.  Neurological morbidity after fetal supraventricular tachyarrhythmia , 1999, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[11]  P. Arnoux,et al.  Amiodarone and digoxin for refractory fetal tachycardia. , 1987, The American journal of cardiology.

[12]  D. Benson,et al.  Clinical and electrophysiologic features of fetal and neonatal paroxysmal atrial tachycardia resulting in congestive heart failure. , 1988, The American journal of cardiology.

[13]  L. Allan,et al.  Flecainide in the treatment of fetal tachycardias. , 1991, British heart journal.

[14]  U. Chitkara,et al.  TRANSPLACENTAL CARDIOVERSION OF INTRAUTERINE SUPRAVENTRICULAR TACHYCARDIA WITH DIGITALIS , 1980, The Lancet.

[15]  J. Simpson,et al.  Outcome of Intermittent Tachyarrhythmias in the Fetus , 1997, Pediatric Cardiology.

[16]  S. Hiraishi,et al.  Successful treatment of supraventricular tachycardia with flecainide acetate: a case report. , 1997, Fetal diagnosis and therapy.