[Investigation of fetal arrhythmias by simultaneous recording of ascending aortic and superior vena caval blood flow].
In a period of 18 consecutive months, all the foetus referred to our Foetal Cardiology Unit for investigation of arrhythmia were systematically assessed by M mode echocardiography and simultaneous recording of blood flow in the superior vena cava and the aorta (SVC/Ao). This study was undertaken to compare the performance of these two approaches. The foetus were classified into three groups according to the arrhythmia diagnosed: Group 1: irregular arrhythmias, Group 2: bradycardias, Group 3: tachycardias. A surface ECG was recorded in all the neonates in whom the arrhythmias persisted. In Group 1, including 50 cases of extrasystoles (49 atrial and 1 ventricular), M mode echo and the Doppler provided the diagnosis in 42 and 47 cases respectively. This difference was not statistically significant. Group 2 comprised four cases of bradycardia (2 blocked atrial bigeminy, 2 complete atrioventricular blocks); the two methods provided the diagnosis in all 4 cases. Group 3 comprised 11 cases including 7 supraventricular tachycardias (SVT), 2 flutter, 1 chaotic atrial rhythm and 1 ectopic junctional rhythm. Complete analysis of these arrhythmias was possible by M mode in 4 cases and by Doppler in all cases. This difference was significant. The distribution of the 7 cases of SVT with respect to the duration of the ventriculoatrial interval was possible by M mode in 2 cases and in all cases by Doppler. This was a decisive factor in the choice of antiarrhythmic therapy. The authors conclude that Doppler and M mode are two echocardiographic approaches which are equally effective in the investigation of foetal atrial extrasystoles and probably of sustained foetal bradycardia. However, Doppler recording of SVC/Ao gives a more detailed and precise diagnosis of more complex foetal arrhythmias.
Fouron
J C
JC
Unité de cardiologie foetale, service de cardiologie, département de pédiatrie, hôpital Sainte-Justine, Université de Montréal 3175 côte Sainte-Catherine, Montréal, Québec, Canada H3T 1C5.
Proulx
F
F
Gosselin
J
J
Infante-Rivard
C
C
D001011:Aorta / Q000000981:diagnostic imaging*; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging* / Q000473:pathology; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012039:Regional Blood Flow; D012680:Sensitivity and Specificity; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging*