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Electrophysiologic features of fetal ventricular aneurysms and diverticula
Author(s) -
Peters Carli,
WackerGussmann Annette,
Strasburger Janette F.,
Cuneo Bettina F.,
Gotteiner Nina L.,
Gulecyuz Mehemet,
Wakai Ronald T.
Publication year - 2015
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.4501
Subject(s) - bigeminy , medicine , cardiology , fetal echocardiography , fetus , magnetocardiography , ventricular tachycardia , prenatal diagnosis , pregnancy , biology , genetics
Objective Congenital ventricular wall defects are very rare and include congenital ventricular aneurysms (CVAs) and diverticula (CVDs). Method We report a series of five fetuses: three with CVAs and two with CVDs referred due to fetal arrhythmia. In addition to routine fetal echocardiography, fetal magnetocardiography (fMCG) was used. The literature in CVA and CVD is reviewed. Results Incessant premature ventricular contractions (PVC), mainly bigeminy and trigeminy were found in three fetuses with CVAs and in one with CVD, who also had ventricular couplets. The other fetus with CVD, referred because of PVCs, had only sinus tachycardia. ST elevation was noted in two. Fetal movement had a variable impact on PVCs. Postnatal evaluation demonstrated two persistent left ventricular aneurysms and one persistent right CVD; one CVD resolved at 35‐week gestation. Two neonates had incessant PVCs. Both arrhythmias resolved spontaneously while being treated with propranolol. Conclusion FMCG is complementary to echocardiographic imaging. In fetuses with left ventricular wall defects, additional electrophysiological diagnosis can be made by fMCG, including the complexity of ventricular ectopy, arrhythmic response to fetal movement, presence of ST‐T wave abnormalities, and atrial amplitude increases. Prenatal risk factor assessment using fMCG can additionally support post‐natal treatment and follow‐up. © 2014 John Wiley & Sons, Ltd.