Key result
A fetus presenting with first-trimester bradycardia secondary to atrial extrasystoles developed paroxysmal supraventricular tachycardia and hydrops fetalis, which recovered spontaneously without medical intervention.
Case Report (n=1)
Atrial ectopic beats can present in the first trimester with fetal bradycardia and evolve into supraventricular tachycardia with hydrops fetalis, highlighting the need for close monitoring despite the potential for spontaneous recovery.
Fetal atrial ectopy may progress to SVT and hydrops; extends known phenotypes but leaves optimal early monitoring open.
We report a fetus with fetal bradycardia at 13 weeks of gestation secondary to atrial extrasystoles. The fetus subsequently developed paroxysmal supraventricular tachycardia and hydrops fetalis. The cardiac arrhythmia recovered spontaneously without any medical intervention. This case illustrates that atrial ectopic beats can present in the first trimester with fetal bradycardia. Rapidly evolving hydrops fetalis secondary to supraventricular tachycardia can develop, warranting close monitoring with weekly heart rate assessment. Fetal bradycardia secondary to atrial extrasystole should be differentiated from first trimester sinus bradycardia and those associated with major structural cardiac abnormality, which have a high fetal loss rate.
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Wong et al. (2002) conducted a case report in Fetal bradycardia secondary to atrial extrasystoles (n=1). Observation (no medical intervention) was evaluated on Recovery of cardiac arrhythmia. A fetus presenting with first-trimester bradycardia secondary to atrial extrasystoles developed paroxysmal supraventricular tachycardia and hydrops fetalis, which recovered spontaneously without medical intervention.
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