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Fetal and neonatal atrial arrhythmias: an association with maternal diabetes and neonatal macrosomia
Author(s) -
Pike J. I.,
Krishnan A.,
Kaltman J.,
Donofrio M. T.
Publication year - 2013
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4210
Subject(s) - medicine , atrial flutter , cardiology , population , atrial tachycardia , premature atrial contraction , tachycardia , in utero , diastole , fetus , heart disease , pregnancy , atrial fibrillation , catheter ablation , blood pressure , environmental health , biology , genetics
Objective To determine if the incidence of maternal diabetes mellitus or neonatal macrosomia is more frequent in fetuses and neonates with atrial arrhythmias than the general population. Methods Fetuses and neonates <30 days of age with atrial flutter or ectopic atrial tachycardia and structurally normal hearts were identified retrospectively through the cardiology databases. Electrocardiograms, echocardiograms, and medical records of mothers and infants were reviewed. Results Thirty‐one patients (15 fetuses, 12 diagnosed in‐utero ) were identified. Infants with atrial flutter or ectopic atrial tachycardia were more likely to be macrosomic or to be born to diabetic mothers than the general population. Two had left atrial dimension z ‐scores above +2, and two had interventricular thickness z ‐scores above +2. Eighteen of 19 had abnormal mitral E/A ratios, suggesting left ventricular diastolic dysfunction. Conclusions Fetuses and neonates with atrial flutter or ectopic atrial tachycardia were more likely to be macrosomic or be born to diabetic mothers than the general population. Postnatal echocardiography suggests that there may be abnormal diastolic left ventricular filling in some babies with these arrhythmias. Independent of ventricular hypertrophy, we speculate that isolated, non‐recurrent fetal or neonatal atrial flutter, or ectopic atrial tachycardia may be caused by cardiac diastolic dysfunction and atrial stretch in utero . © 2013 John Wiley & Sons, Ltd.