-
Journal of Clinical Medicine Jun 2021Fetal arrhythmias are mostly benign and transient. However, some of them are associated with structural defects or can cause heart failure, fetal hydrops, and can lead... (Review)
Review
Fetal arrhythmias are mostly benign and transient. However, some of them are associated with structural defects or can cause heart failure, fetal hydrops, and can lead to intrauterine death. The analysis of fetal heart rhythm is based on ultrasound (M-mode and Doppler echocardiography). Irregular rhythm due to atrial ectopic beats is the most common type of fetal arrhythmia and is generally benign. Tachyarrhythmias are diagnosed when the fetal heart rate is persistently above 180 beats per minute (bpm). The most common fetal tachyarrhythmias are paroxysmal supraventricular tachycardia and atrial flutter. Most fetal tachycardias can be terminated or controlled by transplacental or direct administration of anti-arrhythmic drugs. Fetal bradycardia is diagnosed when the fetal heart rate is slower than 110 bpm. Persistent bradycardia outside labor or in the absence of placental pathology is mostly due to atrioventricular (AV) block. Approximately half of fetal heart blocks are in cases with structural heart defects, and AV block in cases with structurally normal heart is often caused by maternal anti-Ro/SSA antibodies. The efficacy of prenatal treatment for fetal AV block is limited. Our review aims to provide a practical guide for the diagnosis and management of common fetal arrythmias, from the joint perspective of the fetal medicine specialist and the cardiologist.
PubMed: 34204066
DOI: 10.3390/jcm10112510 -
European Journal of Pediatrics Aug 2014Cardiac arrhythmias are very frequent in fetuses and newborns. The prognosis depends on the nature of the arrhythmias but is most often either spontaneously benign or... (Review)
Review
UNLABELLED
Cardiac arrhythmias are very frequent in fetuses and newborns. The prognosis depends on the nature of the arrhythmias but is most often either spontaneously benign or following short-term medication administration. A correct diagnosis is essential for both management and prognosis. It is based on echocardiography during the fetal period and mainly on history, physical exam, and electrocardiogram after birth, but other modalities are available to record transient arrhythmic events. Irregular rhythms are mostly benign and rarely require therapy. In most fetuses and infants, tachyarrhythmias resolve spontaneously or require short-term administration of antiarrhythmics. Approximately one third of these may recur later on, especially during adolescence. Persistent bradyarrhythmias might require pacemaker implantation when associated with failure to thrive or with risk of sudden death.
CONCLUSION
Arrhythmias in fetuses and infants are very common and mostly benign. History, physical exam, and recording of the arrhythmia are essential to make a correct diagnosis and establish an appropriate management for the rare potentially harmful arrhythmias.
Topics: Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Echocardiography; Electrocardiography; Female; Fetus; Heart Rate; Humans; Infant, Newborn; Pregnancy; Treatment Outcome; Ultrasonography, Prenatal
PubMed: 24740881
DOI: 10.1007/s00431-014-2316-4 -
Indian Pacing and Electrophysiology... 2019This article reviews important features for improving the diagnosis and management of fetal arrhythmias. The normal fetal heart rate ranges between 110 and 160 beats per... (Review)
Review
This article reviews important features for improving the diagnosis and management of fetal arrhythmias. The normal fetal heart rate ranges between 110 and 160 beats per minute. A fetal heart rate is considered abnormal if the heart rate is beyond the normal ranges or the rhythm is irregular. The rate, duration, and origin of the rhythm and degree of irregularity usually determine the potential for hemodynamic consequences. Most of the fetal rhythm disturbances are the result of premature atrial contractions (PACs) and are of little clinical significance. Other arrhythmias include tachyarrhythmias (heart rate in excess of 160 beats/min) such as atrioventricular (AV) reentry tachycardia, atrial flutter, and ventricular tachycardia, and bradyarrhythmias (heart rate <110 beats/min) such as sinus node dysfunction, complete heart block (CHB) and long QT syndrome (which is associated with sinus bradycardia and pseudo-heart block).
PubMed: 30817991
DOI: 10.1016/j.ipej.2019.02.007 -
International Journal of Biological... 2017With the fast development of wearable medical device in recent years, it becomes critical to conduct research on continuously measured physiological signals. Entropy is... (Review)
Review
With the fast development of wearable medical device in recent years, it becomes critical to conduct research on continuously measured physiological signals. Entropy is a key metric for quantifying the irregularity and/or complexity contained in human physiological signals. In this review, we focus on exploring how entropy changes in various physiological signals in cardiovascular diseases. Our review concludes that the direction of entropy change relies on the physiological signals under investigation. For heart rate variability and pulse index, the entropy of a healthy person is higher than that of a patient with cardiovascular diseases. For diastolic period variability and diastolic heart sound, the direction of entropy change is reversed. Our conclusion should not only give valuable guidance for further research on the application of entropy in cardiovascular diseases but also provide a foundation for using entropy to analyze the irregularity and/or complexity of physiological signals measured by wearable medical device.
Topics: Animals; Cardiovascular Diseases; Electrocardiography; Entropy; Heart Rate; Humans
PubMed: 29104498
DOI: 10.7150/ijbs.19462 -
Critical Reviews in Biomedical... 2019Heart rate and through-body blood perfusion are vital measurements in all stages of patient care, be it predictive, in the clinical setting, or outpatient monitoring....
Heart rate and through-body blood perfusion are vital measurements in all stages of patient care, be it predictive, in the clinical setting, or outpatient monitoring. Irregular, underachieving, or overperforming heart rate is the main precursor of most cardiovascular diseases that have severe long-term complications. In addition to heart rate, the shape of the pulse waveforms can indicate the heart's valve health and electrophysiology health. The goal of the study was to design a noninvasive device for continuously measuring a patient's heart rate with clinical-grade accuracy along with the ability to indicate pulse waveforms for the patient and physician. An accurate, easy-to-use heart-rate measuring device prototype was developed that did not require the sensor to have direct skin contact to obtain measurements. The statistical analysis of the data gathered by the prototype compared to the data collected from the industry standard device indicated significant correlation. The two-sample T-test for the data recorded from the prototype and the data collected from the industry commercially available pulse oximeter showed a P-value of 0.521, which indicates that there was no significant difference between the prototype and the commercially available pulse oximeter when measuring heart rate.
Topics: Alkenes; Calibration; Electrocardiography; Electrophysiological Phenomena; Equipment Design; Ethylenes; Heart Rate; Humans; Linear Models; Materials Testing; Microcomputers; Movement; Oximetry; Oxygen; Perfusion; Reproducibility of Results; Styrene
PubMed: 31679242
DOI: 10.1615/CritRevBiomedEng.2019026539