Prenatal findings in patients with prolonged QT interval in the neonatal period
Prenatal findings in patients with prolonged QT interval in the neonatal period
复制标题
DOI：
10.1136/hrt.77.3.198
复制
发表时间：
1997-03-01
期刊：
影响因子：
5.7
通讯作者：
Singer, H
中科院分区：
文献类型：
--
作者：
Hofbeck, M;Ulmer, H;Singer, H
描述产前异常的心脏节律在新生儿期QT间期延长的患者。设计-胎儿超声心动图的结果和结果的回顾性分析，在新生儿期QT间期延长的患者谁被称为产前评价。设置-两所大学医院。患者-九例QT间期延长的新生儿期谁被称为产前评价。从妊娠24至40周获得胎儿超声心动图。适应症是胎儿心动过缓（5例），长QT综合征的家族史（2例），和复杂的心律失常（2例patients.Results-Seven胎儿持续窦性心动过缓，无室性心律失常（心率70-120次/分）。5例患者接受普萘洛尔治疗后，诊断已成立的出生后心电图（ECG）。其中一名患者在3周大时突然死亡，因为严重的心动过缓而停止治疗。其余2例未接受普萘洛尔治疗的患者中，1例在6周龄时发生晕厥。两个胎儿表现为由间歇性功能性二度房室传导阻滞引起的室性心动过速和间歇性心动过缓。这两名患者死亡的第一天的生活，尽管治疗心得安和transvenous临时paced. Conclusions，窦性心动过缓，在其他正常胎儿可能是长QT综合征的症状。强烈建议对这些儿童进行产后心电图和家庭检查。对于频发室性心动过速和间歇性二度房室传导阻滞的胎儿，应在产前怀疑长QT综合征。这些高危患者应在设有儿科心脏科的中心分娩。
Objective-To describe prenatal abnormalities of cardiac rhythm in patients with prolonged QT interval in the neonatal period.Design-A retrospective analysis of the results of fetal echocardiography and the outcome in patients with prolonged QT interval in the neonatal period who had been referred for prenatal evaluation.Setting-Two university hospitals.Patients-Nine patients with prolonged QT interval in the neonatal period who had been referred for prenatal evaluation. Fetal echocardiograms were obtained from 24 to 40 weeks of gestation. Indications were fetal bradycardia (five patients), a family history of long QT syndrome (two patients), and complex arrhythmias (two patients).Results-Seven fetuses had persistent sinus bradycardia without ventricular arrhythmias (heart rates 70-120 beats/min). Five patients were treated with propranolol, after the diagnosis had been established by postnatal electrocardiogram (ECG). One of these patients died suddenly at the age of 3 weeks, after the treatment had been stopped because of profound bradycardia. One of the remaining two patients who did not receive propranolol had a syncope at the age of 6 weeks. Two fetuses presented with frequent runs of ventricular tachycardia and intermittent bradycardia caused by intermittent, functional second degree atrioventricular block. Both patients died on the first day of life despite treatment with propranolol and transvenous temporary pacing.Conclusions-Sinus bradycardia in an otherwise normal fetus may be a symptom of long QT syndrome. Postnatal ECGs and a family examination are strongly recommended in these children. In fetuses with frequent runs of ventricular tachycardia and intermittent second degree atrioventricular block long QT syndrome should be suspected prenatally. These high risk patients should be delivered in centres with a paediatric cardiology unit.