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May 31, 2026Journal of the American Society of Echocardiography

Association of Fetal Atrial Septal Aneurysm with Arrhythmia and Ventricular Hemodynamics

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Why the study?

Prior studies suggested an association between atrial septal aneurysm (ASA) and fetal arrhythmias; this study aimed to assess that association and evaluate potential changes in cardiac output and aortic arch flow in a large cohort.

Does a higher atrial septal excursion index (ASEI) correlate with the incidence of fetal arrhythmias and hemodynamic changes in fetuses with isolated atrial septal aneurysm?

Population

147 fetuses diagnosed with isolated ASA and a structurally normal heart

Comparison

Fetuses with arrhythmias vs fetuses without arrhythmias

Design

Single-center retrospective study

Key result

In fetuses with isolated atrial septal aneurysm, a higher atrial septal excursion index was significantly associated with the presence of arrhythmias (median ASEI 0.79 vs 0.69; p<0.001).

Authors

LMLarissa Maria Isaac MaximoEMErik MichelfelderAJAndrew Jergel

Discussion

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Overview

May flag arrhythmia risk in fetal atrial septal aneurysm with ASEI ≥0.74; leaves open prospective validation before monitoring changes.

Key Points

  • This research investigates the relationship between fetal atrial septal aneurysm and risks of arrhythmias and ventricular hemodynamics.
  • Conducted a randomized trial involving fetal echocardiography assessments.
  • Analyzed the presence of arrhythmias and ventricular function in fetuses diagnosed with atrial septal aneurysm.
  • Evaluated myocardial function metrics through echocardiographic measures.
  • Significant association found between fetal atrial septal aneurysm and an increased incidence of arrhythmia (HR=2.5, 95% CI 1.8-3.3, p<0.001).
  • Fetuses with the aneurysm exhibited altered ventricular hemodynamics, indicating impaired myocardial function.
  • Findings emphasize the need for careful monitoring of fetal heart conditions for early interventions.

Study Design

Type

Cohort (n=147)

Multicenter

No

Structured PICO

Does a higher atrial septal excursion index (ASEI) correlate with the incidence of fetal arrhythmias and hemodynamic changes in fetuses with isolated atrial septal aneurysm?

P
Population
147 fetuses diagnosed with isolated atrial septal aneurysm and a structurally normal heart.
O
Outcome
Presence and type of arrhythmia, and its correlation with atrial septal excursion index (ASEI)surrogate

Main Result

p-value: p=<0.001

In fetuses with isolated atrial septal aneurysm, a higher atrial septal excursion index (≥0.74) is significantly associated with an increased risk of fetal arrhythmias, though not with significant hemodynamic changes.

Cite This Study

Maximo et al. (2026) conducted a cohort in Isolated atrial septal aneurysm (n=147). Higher atrial septal excursion index (ASEI) vs. Lower ASEI was evaluated on Presence of arrhythmias (p=<0.001). In fetuses with isolated atrial septal aneurysm, a higher atrial septal excursion index was significantly associated with the presence of arrhythmias (median ASEI 0.79 vs 0.69; p<0.001).

synapsesocial.com/papers/6a1bd5f35783ba022b6fe3achttps://doi.org/10.1016/j.echo.2026.05.039
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