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Association of Fetal Atrial Flutter with Neonatal Atrioventricular Re-entry Tachycardia Involving Accessory Pathway: A Link to be Remembered

Gulhan Tunca Sahin, Michael Lewis, Orhan Uzun

Pediatric Cardiology, Volume: 42, Issue: 4, Pages: 849 - 856

Swansea University Authors: Michael Lewis, Orhan Uzun

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DOI (Published version): 10.1007/s00246-021-02549-6

Abstract

To investigate prenatal and postnatal outcomes of atrial flutter and its association with the development of a second tachycardia, following restoration of sinus rhythm, in the fetus or newborn. This study is a retrospective review of all fetuses that presented with atrial flutter from January 2001...

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Published in: Pediatric Cardiology
ISSN: 0172-0643 1432-1971
Published: Springer Science and Business Media LLC 2021
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URI: https://cronfa.swan.ac.uk/Record/cronfa56189
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first_indexed 2021-02-04T10:41:01Z
last_indexed 2021-06-08T03:20:17Z
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2021-06-07T14:49:13.7163436</datestamp><bib-version>v2</bib-version><id>56189</id><entry>2021-02-04</entry><title>Association of Fetal Atrial Flutter with Neonatal Atrioventricular Re-entry Tachycardia Involving Accessory Pathway: A Link to be Remembered</title><swanseaauthors><author><sid>b59c8f5c056bac7e6995385f22ad1639</sid><firstname>Michael</firstname><surname>Lewis</surname><name>Michael Lewis</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>8b8630f06c6ac19df83a3aeb6aec3a08</sid><firstname>Orhan</firstname><surname>Uzun</surname><name>Orhan Uzun</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2021-02-04</date><deptcode>FGSEN</deptcode><abstract>To investigate prenatal and postnatal outcomes of atrial flutter and its association with the development of a second tachycardia, following restoration of sinus rhythm, in the fetus or newborn. This study is a retrospective review of all fetuses that presented with atrial flutter from January 2001 to December 2019 at the University Hospital of Wales, Cardiff, UK. The specific type of arrhythmia, its time of appearance and clinical characteristics, echocardiographic findings, medical management, and postnatal outcomes were evaluated. Sixteen fetuses were diagnosed with atrial flutter (AFL). Thirteen fetuses had persistent AFL and three fetuses had intermittent AFL. Seven patients had hydrops, of which one had Ebstein&#x2019;s anomaly and the other six had normal hearts. Three of the fetuses that presented with AFL were diagnosed at 20, 21, and 23 weeks&#x2019; gestation and the remainder were diagnosed in the third trimester. Thirteen patients with AFL received antiarrhythmic drugs and three were delivered without any treatment. Five fetuses with AFL developed atrioventricular reciprocating tachycardia following DC cardioversion after birth, and four of them exhibited pre-excitation on the ECG. These five patients (31.3%) required postnatal antiarrhythmic treatment for up to 2 years. Pre-excitation disappeared in two patients during follow-up and two asymptomatic patients with neonatal pre-excitation required accessory pathway ablation. Fetal atrial flutter has a strong association with atrioventricular reciprocating tachycardia and ventricular pre-excitation in the neonatal period. Therefore, electrocardiograms should be carefully reviewed in newborns following the initial resolution of atrial flutter.</abstract><type>Journal Article</type><journal>Pediatric Cardiology</journal><volume>42</volume><journalNumber>4</journalNumber><paginationStart>849</paginationStart><paginationEnd>856</paginationEnd><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0172-0643</issnPrint><issnElectronic>1432-1971</issnElectronic><keywords>Atrial futter; Fetus; Pre-excitation; Tachycardia; Neonate</keywords><publishedDay>1</publishedDay><publishedMonth>4</publishedMonth><publishedYear>2021</publishedYear><publishedDate>2021-04-01</publishedDate><doi>10.1007/s00246-021-02549-6</doi><url/><notes/><college>COLLEGE NANME</college><department>Science and Engineering - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGSEN</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2021-06-07T14:49:13.7163436</lastEdited><Created>2021-02-04T10:39:55.9970048</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Gulhan Tunca</firstname><surname>Sahin</surname><order>1</order></author><author><firstname>Michael</firstname><surname>Lewis</surname><order>2</order></author><author><firstname>Orhan</firstname><surname>Uzun</surname><order>3</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2021-06-07T14:49:13.7163436 v2 56189 2021-02-04 Association of Fetal Atrial Flutter with Neonatal Atrioventricular Re-entry Tachycardia Involving Accessory Pathway: A Link to be Remembered b59c8f5c056bac7e6995385f22ad1639 Michael Lewis Michael Lewis true false 8b8630f06c6ac19df83a3aeb6aec3a08 Orhan Uzun Orhan Uzun true false 2021-02-04 FGSEN To investigate prenatal and postnatal outcomes of atrial flutter and its association with the development of a second tachycardia, following restoration of sinus rhythm, in the fetus or newborn. This study is a retrospective review of all fetuses that presented with atrial flutter from January 2001 to December 2019 at the University Hospital of Wales, Cardiff, UK. The specific type of arrhythmia, its time of appearance and clinical characteristics, echocardiographic findings, medical management, and postnatal outcomes were evaluated. Sixteen fetuses were diagnosed with atrial flutter (AFL). Thirteen fetuses had persistent AFL and three fetuses had intermittent AFL. Seven patients had hydrops, of which one had Ebstein’s anomaly and the other six had normal hearts. Three of the fetuses that presented with AFL were diagnosed at 20, 21, and 23 weeks’ gestation and the remainder were diagnosed in the third trimester. Thirteen patients with AFL received antiarrhythmic drugs and three were delivered without any treatment. Five fetuses with AFL developed atrioventricular reciprocating tachycardia following DC cardioversion after birth, and four of them exhibited pre-excitation on the ECG. These five patients (31.3%) required postnatal antiarrhythmic treatment for up to 2 years. Pre-excitation disappeared in two patients during follow-up and two asymptomatic patients with neonatal pre-excitation required accessory pathway ablation. Fetal atrial flutter has a strong association with atrioventricular reciprocating tachycardia and ventricular pre-excitation in the neonatal period. Therefore, electrocardiograms should be carefully reviewed in newborns following the initial resolution of atrial flutter. Journal Article Pediatric Cardiology 42 4 849 856 Springer Science and Business Media LLC 0172-0643 1432-1971 Atrial futter; Fetus; Pre-excitation; Tachycardia; Neonate 1 4 2021 2021-04-01 10.1007/s00246-021-02549-6 COLLEGE NANME Science and Engineering - Faculty COLLEGE CODE FGSEN Swansea University 2021-06-07T14:49:13.7163436 2021-02-04T10:39:55.9970048 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Gulhan Tunca Sahin 1 Michael Lewis 2 Orhan Uzun 3
title Association of Fetal Atrial Flutter with Neonatal Atrioventricular Re-entry Tachycardia Involving Accessory Pathway: A Link to be Remembered
spellingShingle Association of Fetal Atrial Flutter with Neonatal Atrioventricular Re-entry Tachycardia Involving Accessory Pathway: A Link to be Remembered
Michael Lewis
Orhan Uzun
title_short Association of Fetal Atrial Flutter with Neonatal Atrioventricular Re-entry Tachycardia Involving Accessory Pathway: A Link to be Remembered
title_full Association of Fetal Atrial Flutter with Neonatal Atrioventricular Re-entry Tachycardia Involving Accessory Pathway: A Link to be Remembered
title_fullStr Association of Fetal Atrial Flutter with Neonatal Atrioventricular Re-entry Tachycardia Involving Accessory Pathway: A Link to be Remembered
title_full_unstemmed Association of Fetal Atrial Flutter with Neonatal Atrioventricular Re-entry Tachycardia Involving Accessory Pathway: A Link to be Remembered
title_sort Association of Fetal Atrial Flutter with Neonatal Atrioventricular Re-entry Tachycardia Involving Accessory Pathway: A Link to be Remembered
author_id_str_mv b59c8f5c056bac7e6995385f22ad1639
8b8630f06c6ac19df83a3aeb6aec3a08
author_id_fullname_str_mv b59c8f5c056bac7e6995385f22ad1639_***_Michael Lewis
8b8630f06c6ac19df83a3aeb6aec3a08_***_Orhan Uzun
author Michael Lewis
Orhan Uzun
author2 Gulhan Tunca Sahin
Michael Lewis
Orhan Uzun
format Journal article
container_title Pediatric Cardiology
container_volume 42
container_issue 4
container_start_page 849
publishDate 2021
institution Swansea University
issn 0172-0643
1432-1971
doi_str_mv 10.1007/s00246-021-02549-6
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 0
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description To investigate prenatal and postnatal outcomes of atrial flutter and its association with the development of a second tachycardia, following restoration of sinus rhythm, in the fetus or newborn. This study is a retrospective review of all fetuses that presented with atrial flutter from January 2001 to December 2019 at the University Hospital of Wales, Cardiff, UK. The specific type of arrhythmia, its time of appearance and clinical characteristics, echocardiographic findings, medical management, and postnatal outcomes were evaluated. Sixteen fetuses were diagnosed with atrial flutter (AFL). Thirteen fetuses had persistent AFL and three fetuses had intermittent AFL. Seven patients had hydrops, of which one had Ebstein’s anomaly and the other six had normal hearts. Three of the fetuses that presented with AFL were diagnosed at 20, 21, and 23 weeks’ gestation and the remainder were diagnosed in the third trimester. Thirteen patients with AFL received antiarrhythmic drugs and three were delivered without any treatment. Five fetuses with AFL developed atrioventricular reciprocating tachycardia following DC cardioversion after birth, and four of them exhibited pre-excitation on the ECG. These five patients (31.3%) required postnatal antiarrhythmic treatment for up to 2 years. Pre-excitation disappeared in two patients during follow-up and two asymptomatic patients with neonatal pre-excitation required accessory pathway ablation. Fetal atrial flutter has a strong association with atrioventricular reciprocating tachycardia and ventricular pre-excitation in the neonatal period. Therefore, electrocardiograms should be carefully reviewed in newborns following the initial resolution of atrial flutter.
published_date 2021-04-01T04:10:58Z
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