Location of accessory connection in infants presenting with supraventricular tachycardia in utero: Clinical correlations

Prince J. Kannankeril*, Nina L. Gotteiner, Barbara J. Deal, Christopher L. Johnsrude, Janette F. Strasburger

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

The most common mechanism of fetal tachycardia is orthodromic reciprocating tachycardia utilizing an accessory atrioventricular connection, however, data regarding accessory connection location in patients with fetal tachycardia is limited. To investigatethe location of accessory connections in fetal tachycardia, postnatal transesophageal electrophysiology studies were performed at one institution over a 10-year period in 24 infants with documented fetal tachycardia. The 18 infants with inducible orthodromic reciprocating tachycardia were grouped according to accessory connection location, and groups were compared regarding prenatal presentation and clinical course. Left-sided connections were found in 13 (72%) patients, while accessory connection location could not be determined in the remaining 5 (28%) patients. The presence of a left-sided accessory connection was associated with sustained tachycardia, depressed ventricular function, and the need for antiarrhythmic therapy in utero. No other difference in clinical or electrophysiologic data was found between groups. Our findings indicate that a high proportion of patients with fetal tachycardia have left-sided accessory connections, and a left-sided connection may adversely affect fetal hemodynamics and cardiac output.

Original languageEnglish (US)
Pages (from-to)115-119
Number of pages5
JournalAmerican journal of perinatology
Volume20
Issue number3
DOIs
StatePublished - Apr 1 2003

Keywords

  • Prenatal diagnosis
  • Supraventricular tachycardia
  • Wolff-Parkinson-White syndrome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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