The incremental benefit of color tissue doppler in fetal arrhythmia assessment
ABC., imagem cardiovasc
; 31(4 supl.1): 30-30, out., 2018.
Article
in English
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1026076
Responsible library:
BR79.1
ABSTRACT
BACKGROUND:
Accurate fetal arrhythmia diagnosis is key for effective management. Standard echo-based techniques (M-mode and spectral Doppler) require adequate fetal position and cursor alignment to define temporal relationships of mechanical events. Little data exists on the application of cTDI in fetal rhythm assessment.OBJECTIVE:
We sought to determine the benefit of color tissue Doppler imaging (cTDI) in fetal arrhythmia assessment over conventional fetal echo techniques.METHODS:
Pregnancies with a diagnosis of fetal arrhythmia were prospectively recruited to undergo cTDI following fetal echocardiography. Multiple cycle 4-chamber clips in any orientation were recorded (frame rates >180 fps). With offline analysis, sample-volumes were placed on atrial (A) and ventricular (V) free walls with simultaneous recordings. A and V rates, intervals and relationships were evaluated.RESULTS:
Arrhythmias were assessed in 45 fetuses by cTDI at 15-39 weeks and included 11 atrial and 5 ventricular ectopic beats; 18 supraventricular tachyarrhythmias (SVT) including ectopic atrial tachycardia in 11, AV re-entry SVT in 4, atrial flutter (AF) in 2, intermittent AF and junctional ectopic rhythm in 1; ventricular tachycardias in 3; 8 bradycardias or AV conduction pathology including complete AV block (AVB) in 5, 1 AVB evolving into complete AVB in 1, 2 AVB in 1, sinus bradycardia in 1. Arrhythmia diagnosis by cTDI could be made irrespective of orientation of the fetus, after training, within 10-15 minutes. cTDI findings concurred with the diagnosis by standard techniques in 95% of cases and added new findings in 29%. In 5%, cTDI provided a new diagnosis, confirmed postnatally. In cases with SVT, cTDI permitted assessment of A-V and V-A intervals elucidating arrhythmia mechanism in all, whereas standard techniques had failed to define mechanism in 45%.CONCLUSION:
cTDI with offline analysis permits rapid and accurate definition of fetal arrhythmia mechanism, providing new information in a significant proportion of affected pregnancies. (AU)
Full text:
Available
Collection:
National databases
/
Brazil
Database:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Arrhythmias, Cardiac
/
Echocardiography, Doppler, Color
/
Fetus
Limits:
Humans
Language:
English
Journal:
ABC., imagem cardiovasc
Year:
2018
Document type:
Article
/
Congress and conference
Institution/Affiliation country:
Instituto Dante Pazzanese de Cardiologia/BR