Fetal Bradyarrhythmia Associated With Congenital Heart Defects – Nationwide Survey in Japan –
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- Miyoshi Takekazu
- National Cerebral and Cardiovascular Center
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- Maeno Yasuki
- Kurume University School of Medicine
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- Sago Haruhiko
- National Center for Child Health and Development
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- Inamura Noboru
- Osaka Medical Center and Research Institute for Maternal and Child Health
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- Yasukouchi Satoshi
- Nagano Children’s Hospital
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- Kawataki Motoyoshi
- Kanagawa Children’s Medical Center
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- Horigome Hitoshi
- University of Tsukuba
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- Yoda Hitoshi
- Toho University Omori Medical Center
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- Taketazu Mio
- Saitama Medical University International Medical Center
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- Shozu Makio
- Chiba University
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- Nii Masaki
- Shizuoka Children’s Hospital
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- Kato Hitoshi
- National Center for Child Health and Development
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- Hagiwara Akiko
- Kanagawa Children’s Medical Center
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- Omoto Akiko
- Chiba University
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- Shimizu Wataru
- Nippon Medical School
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- Shiraishi Isao
- National Cerebral and Cardiovascular Center
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- Sakaguchi Heima
- National Cerebral and Cardiovascular Center
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- Nishimura Kunihiro
- National Cerebral and Cardiovascular Center
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- Nakai Michikazu
- National Cerebral and Cardiovascular Center
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- Ueda Keiko
- National Cerebral and Cardiovascular Center
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- Katsuragi Shinji
- National Cerebral and Cardiovascular Center
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- Ikeda Tomoaki
- Mie University
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Background:Because there is limited information on fetal bradyarrhythmia associated with congenital heart defects (CHD), we investigated its prognosis and risk factors.Methods and Results:In our previous nationwide survey of fetal bradyarrhythmia from 2002 to 2008, 38 fetuses had associated CHD. Detailed clinical data were collected from secondary questionnaires on 29 fetuses from 18 institutions, and were analyzed. The 29 fetuses included 22 with isomerism, 4 with corrected transposition of the great arteries (TGA) and 3 with critical pulmonary stenosis; 14 had complete atrioventricular block (AVB), 8 had second-degree AVB, and 16 had sick sinus syndrome; 5 died before birth, and 10 died after birth (5 in the neonatal period). Neonatal and overall survival rates for fetal bradyarrhythmia with CHD were 66% and 48%, respectively. Pacemaker implantation was needed in 17 cases (89%). Beta-sympathomimetics were administered in utero in 13 cases and were effective in 6, but were not associated with prognosis. All cases of corrected TGA or ventricular rate ≥70 beats/min survived. A ventricular rate <55 beats/min had significant effects on fetal myocardial dysfunction (P=0.02) and fetal hydrops (P=0.04), resulting in high mortality.Conclusions:The prognosis of fetal bradyarrhythmia with CHD is still poor. The type of CHD, fetal myocardial dysfunction, and fetal hydrops were associated with a poor prognosis, depending on the ventricular rate. (Circ J 2015; 79: 854–861)
収録刊行物
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- Circulation Journal
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Circulation Journal 79 (4), 854-861, 2015
一般社団法人 日本循環器学会
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詳細情報
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- CRID
- 1390282680084184320
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- NII論文ID
- 130005130254
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- NII書誌ID
- AA11591968
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- ISSN
- 13474820
- 13469843
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- NDL書誌ID
- 026283943
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- PubMed
- 25739568
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
- KAKEN
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- 抄録ライセンスフラグ
- 使用不可