title: Persistent fetal sinus bradycardia associated with maternal anti-SSA/Ro and anti-SSB/La antibodies.
abstract: OBJECTIVE
  To study the clinical course and outcome of fetal sinus bradycardia (SB) due to maternal antibody-induced sinus node dysfunction.
  
  
  METHODS
  We reviewed the maternal, prenatal, and postnatal findings of fetuses with SB associated with elevated maternal anti-SSA/Ro and anti-SSB/La antibodies.
  
  
  RESULTS
  Of the 6 cases diagnosed prenatally, 3 had isolated SB persisting after birth and had a good prognosis. Three fetuses with SB and severe myocardial involvement (congenital complete heart block and/or endocardial fibroelastosis) succumbed in utero in spite of treatment. Postmortem histopathology in 1 fetus showed inflammatory destruction of the sinus and atrioventricular nodes. SB was detected incidentally in a 7-year-old girl. She had intermittent heart block with progressive sinus arrest requiring permanent pacemaker.
  
  
  CONCLUSIONS
  Fetal SB associated with maternal autoantibodies may persist in childhood, with a good prognosis in the absence of widespread cardiac involvement.
authors.affiliation: Department of Pediatric Cardiology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Priya
authors.initials: P
authors.lastname: Chockalingam
authors.forename: Edgar T
authors.initials: ET
authors.lastname: Jaeggi
authors.forename: Lukas A
authors.initials: LA
authors.lastname: Rammeloo
authors.forename: Monique C
authors.initials: MC
authors.lastname: Haak
authors.forename: Phebe N
authors.initials: PN
authors.lastname: Adama van Scheltema
authors.forename: Johannes M P J
authors.initials: JM
authors.lastname: Breur
authors.forename: Margot M
authors.initials: MM
authors.lastname: Bartelings
authors.forename: Sally-Ann B
authors.initials: SA
authors.lastname: Clur
authors.forename: Nico A
authors.initials: NA
authors.lastname: Blom
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000276:immunology*; D001324:Autoantigens / Q000276:immunology; D001919:Bradycardia / Q000276:immunology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005333:Fetus / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology*; D006327:Heart Block / Q000151:congenital / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D011247:Pregnancy / Q000276:immunology*; D012261:Ribonucleoproteins / Q000276:immunology; D012804:Sick Sinus Syndrome / Q000276:immunology* / Q000503:physiopathology; D000097585:SS-B Antigen; D000099207:SS-A Antigen
chemical_list: D000974:Antibodies, Antinuclear; D001324:Autoantigens; D012261:Ribonucleoproteins; D000097585:SS-B Antigen; D000099207:SS-A Antigen; C035356:SS-A antibodies; C035357:SS-B antibodies