title: Diagnosis and treatment of fetal arrhythmia.
abstract: OBJECTIVE
  Detection and careful stratification of fetal heart rate (FHR) is extremely important in all pregnancies. The most lethal cardiac rhythm disturbances occur during apparently normal pregnancies where FHR and rhythm are regular and within normal or low-normal ranges. These hidden depolarization and repolarization abnormalities, associated with genetic ion channelopathies cannot be detected by echocardiography, and may be responsible for up to 10% of unexplained fetal demise, prompting a need for newer and better fetal diagnostic techniques. Other manifest fetal arrhythmias such as premature beats, tachycardia, and bradycardia are commonly recognized.
  
  
  METHODS
  Heart rhythm diagnosis in obstetrical practice is usually made by M-mode and pulsed Doppler fetal echocardiography, but not all fetal cardiac time intervals are captured by echocardiographic methods.
  
  
  CONCLUSIONS
  This article reviews different types of fetal arrhythmias, their presentation and treatment strategies, and gives an overview of the present and future diagnostic techniques.
authors.affiliation: Department of Neonatology, University Children's Hospital, Tuebingen, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Wacker-Gussmann
authors.affiliation: Division of Cardiology, Department of Pediatrics, Children's Hospital of Wisconsin-Milwaukee and Fox Valley, Milwaukee, Wisconsin.
authors.forename: Janette F
authors.initials: JF
authors.lastname: Strasburger
authors.affiliation: Division of Cardiology, Department of Pediatrics, Children's Hospital Colorado, Denver, Colorado.
authors.forename: Bettina F
authors.initials: BF
authors.lastname: Cuneo
authors.affiliation: Department of Medical Physics, University of Wisconsin, Madison, Wisconsin.
authors.forename: Ronald T
authors.initials: RT
authors.lastname: Wakai
mesh_terms: D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000000981:diagnostic imaging; D001919:Bradycardia / Q000175:diagnosis / Q000209:etiology; D015148:Cardiotocography; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D013610:Tachycardia / Q000175:diagnosis; D016216:Ultrasonography, Prenatal / Q000379:methods