Fetal arrhythmia and long-term outcome

Fetal arrhythmia and long-term outcome

Background:
Fetal cardiac arrhythmia are detected in approximately 1% of all fetuses, most
of these rhythm disturbances are the result of extrasystoles and are of little
clinical significance. However, some types of arrhythmias are of clinical
significance because they can cause fetal compromise, which may lead to the
death of the affected fetus; persistent tachycardia and atrioventricular block
are associated with fetal and postnatal mortality. Therefore these arrhythmia
need immediate examination and if necessary therapy. Ultrasound examination is
performed to exclude congenital heart defects and to differentiate the type of
arrhythmia. Therapy can be induced preterm delivery or intrauterine treatment.

To estimate the cardiologic and neuropsychologic long term outcome in children
born after fetal arrhythmia.

Retrospective analysis:
In our ultrasound data-base all pregnancies were selected with the diagnosis
fetal arrhythmia in the period january 1993 untill december 2005. From the
data-base of the pediatric cardiology department we selected all neonates with
fetal arrhythmia.

Follow-up:
First the referring physicians will be contacted to complete the short term
follow-up. It concerns written information on the pregnancy, delivery and
puerperium. Then, the general physicians of the families will be notified, on
paper and by telephone. If there are no contraindications, the families will be
contacted by letter and by telephone. The families will be asked to
participate in the study. It involves a standard pediatric cardiologic
examination and ECG by a child cardiologist and a neuropsychologic test. The
child will not undergo invasive tests. Every examination will take plusminus 60
minutes. With anamnesis of the parents and the child we want to examine the
neurologic and cardiologic condition of the child. In case of abnormalities
detected by the examination, the familiy physician will be notified and it will
be discussed with the parents. The responsibility for the neuropsychologic test
is with dr J. Feenstra (psychologist) and for responsible for the pediatric
cardiologic examination is dr N.A. Blom (child cardiologist).

According to the examiners there is little to no burden or risk for the
children who are being examined.