The diagnosis and management of long QT syndrome based on fetal echocardiography

Figures

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  Figure 1. Detailed timeline of fetal and maternal characteristics. The fetal heart rate is shown at the bottom half of the figure with superimposed 3rd, 50th, and 97th heart rate percentiles in hatched parallel lines (adapted from Mitchell and colleagues7). The horizontal dotted line represents the standard obstetric definition of fetal bradycardia (ie, 110 beats/min). The vertical line represents admission to the hospital for initiation of transplacental therapy. There is a marked reduction in fetal arrhythmia associated with therapy prior to eventual delivery at 37 weeks’ gestation. BP = blood pressure; VT = ventricular tachycardia.

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  Figure 2. Fetal echocardiogram M-mode still image demonstrating an episode of ventricular tachycardia of variable cycle length, with ventriculoatrial dissociation and a nonvariable, normal atrial rate. The interval between each beat is labeled in milliseconds.

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  Figure 3. Electrocardiogram taken on the first day of life, demonstrating 2:1 atrioventricular block with frequent multiform premature ventricular contractions and a corrected QT interval of 680 ms. This study was performed before initiation of postnatal medical therapy.