Successful prenatal management of ventricular tachycardia and second-degree atrioventricular block in fetal long QT syndrome Akira Miyake, MD, Heima.

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Presentation transcript:

Successful prenatal management of ventricular tachycardia and second-degree atrioventricular block in fetal long QT syndrome Akira Miyake, MD, Heima Sakaguchi, MD, Aya Miyazaki, MD, Takekazu Miyoshi, MD, Takeshi Aiba, MD, Isao Shiraishi, MD HeartRhythm Case Reports Volume 3, Issue 1, Pages 53-57 (January 2017) DOI: 10.1016/j.hrcr.2016.09.001 Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 1 Case 1. A: At 29 weeks, a fetal echocardiogram showed ventricular tachycardia (VT) with a ventricular rate of 220 beats per minute (bpm), compared with an atrial rate of 130 bpm. B: Fetal magnetocardiography (fMCG) revealed polymorphic VT. C: fMCG showed a prolonged QT interval (591 ms) during sinus rhythm. HeartRhythm Case Reports 2017 3, 53-57DOI: (10.1016/j.hrcr.2016.09.001) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 2 Case 1. A: The infant’s heart rate at the time of birth was 56 beats per minute (bpm), and he had a 2:1 atrioventricular block. B: On the 14th day of life, the electrocardiogram showed a sinus rhythm with a left bundle branch block pattern. C: At the age of 5 months, an implantable cardioverter-defibrillator was implanted. HeartRhythm Case Reports 2017 3, 53-57DOI: (10.1016/j.hrcr.2016.09.001) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 3 Case 2. A: At 24 weeks’ gestation, the initial fetal echocardiography showed fetal ventricular tachycardia with a ventricular rate of 187 beats per minute (bpm) and an atrial rate of 123 bpm. B: Fetal magnetocardiography (fMCG) revealed sustained ventricular tachycardia with a V rate of 220 bpm. C: fMCG showed a prolonged QT interval (511 ms) during transient sinus rhythm. D: At this time, the fetus also developed ascites, skin edema, and pericardial effusion as symptoms of severe hydrops. HeartRhythm Case Reports 2017 3, 53-57DOI: (10.1016/j.hrcr.2016.09.001) Copyright © 2016 Heart Rhythm Society Terms and Conditions