Fetal Bradyarrhythmia Associated With Congenital Heart Defects　– Nationwide Survey in Japan –

• Miyoshi Takekazu

  National Cerebral and Cardiovascular Center

• Maeno Yasuki

  Kurume University School of Medicine

• Sago Haruhiko

  National Center for Child Health and Development

• Inamura Noboru

  Osaka Medical Center and Research Institute for Maternal and Child Health

• Yasukouchi Satoshi

  Nagano Children’s Hospital

• Kawataki Motoyoshi

  Kanagawa Children’s Medical Center

• Horigome Hitoshi

  University of Tsukuba

• Yoda Hitoshi

  Toho University Omori Medical Center

• Taketazu Mio

  Saitama Medical University International Medical Center

• Shozu Makio

  Chiba University

• Nii Masaki

  Shizuoka Children’s Hospital

• Kato Hitoshi

  National Center for Child Health and Development

• Hagiwara Akiko

  Kanagawa Children’s Medical Center

• Omoto Akiko

  Chiba University

• Shimizu Wataru

  Nippon Medical School

• Shiraishi Isao

  National Cerebral and Cardiovascular Center

• Sakaguchi Heima

  National Cerebral and Cardiovascular Center

• Nishimura Kunihiro

  National Cerebral and Cardiovascular Center

• Nakai Michikazu

  National Cerebral and Cardiovascular Center

• Ueda Keiko

  National Cerebral and Cardiovascular Center

• Katsuragi Shinji

  National Cerebral and Cardiovascular Center

• Ikeda Tomoaki

  Mie University

Abstract

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)

Journal

• Circulation Journal

  Circulation Journal 79 (4), 854-861, 2015

  The Japanese Circulation Society

Keywords

• Atrioventricular block
• Bradyarrhythmia
• Congenital heart defects
• Fetus
• Left atrial isomerism

Details

• CRID: 1390282680084184320
• NII Article ID: 130005130254
• NII Book ID: AA11591968
• DOI: 10.1253/circj.cj-14-0978
• ISSN: 13474820
• ISSN: 13469843
• NDL BIB ID: 026283943
• PubMed: 25739568
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I026283943
• Web Site: https://www.jstage.jst.go.jp/article/circj/79/4/79_CJ-14-0978/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2015311444
• Text Lang: en
• Data Source:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed