Location of accessory connection in infants presenting with supraventricular tachycardia in utero: clinical correlations.

Abstract:

:The most common mechanism of fetal tachycardia is orthodromic reciprocating tachycardia utilizing an accessory atrioventricular connection, however, data regarding accessory connection location in patients with fetal tachycardia is limited. To investigate the location of accessory connections in fetal tachycardia, postnatal transesophageal electrophysiology studies were performed at one institution over a 10-year period in 24 infants with documented fetal tachycardia. The 18 infants with inducible orthodromic reciprocating tachycardia were grouped according to accessory connection location, and groups were compared regarding prenatal presentation and clinical course. Left-sided connections were found in 13 (72%) patients, while accessory connection location could not be determined in the remaining 5 (28%) patients. The presence of a left-sided accessory connection was associated with sustained tachycardia, depressed ventricular function, and the need for antiarrhythmic therapy in utero. No other difference in clinical or electrophysiologic data was found between groups. Our findings indicate that a high proportion of patients with fetal tachycardia have left-sided accessory connections, and a left-sided connection may adversely affect fetal hemodynamics and cardiac output.

journal_name

Am J Perinatol

authors

Kannankeril PJ,Gotteiner NL,Deal BJ,Johnsrude CL,Strasburger JF

doi

10.1055/s-2003-40014

subject

Has Abstract

pub_date

2003-04-01 00:00:00

pages

115-9

issue

3

eissn

0735-1631

issn

1098-8785

journal_volume

20

pub_type

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