Fetal Arrhythmias

65 Pages·2017·3.49 MB·English

Fetal Arrhythmias
April 6, 2017 Glendale, AZ
Christopher L Lindblade, MD
Director, Fetal Cardiology Program
Phoenix Children’s Hospital
No Financial Disclosures
• I have no financial relationship with any
manufacturer of any commercial product
and/or provider of commercial services
discussed in the conference.
• I do not intend to discuss an
unapproved/investigative use of a commercial
product or device in my presentation
Arrhythmia Evaluation
• Rate
– Fast or slow?

• Rhythm
– Regular or irregular?
– Atrial rhythm or ventricular rhythm?
Normal Conduction
Fetal Arrhythmia Background
• Complicates ~2% of all pregnancies
• Account for 10-20% of referrals to pediatric cardiologist
• Abnormal impulse generation or propagation
• Various techniques
– Fetal ECG
– Magnetocardiography (fMCG)
2:1 AV Block
Fetal Arrhythmia Background
• Complicates ~2% of all pregnancies
• Account for 10-20% of referrals to pediatric cardiologist
• Abnormal impulse generation or propagation
• Techniques
– Fetal ECG
– Magnetocardiography (fMCG)
– Echocardiography

Assess with M-mode or spectral Doppler
Color and tissue Doppler may be helpful
M-Mode Assessment
• Place cursor across ventricular and atrial wall
1:1 AV Conduction
Right Ventricle
Left Atrium
Color M-Mode Assessment
Atrial
Ventricular
Spectral Doppler
Assessment
• E = early passive
ventricular inflow
from atrium

• A = active atrial
A
systolic contraction
stimulated by SA E
node, mechanical
event correlating
with atrial electrical
stimulation
V
Spectral Doppler Assessment
MV-LVOT
A
E
V