Key result
Fetal Doppler SVC-Ao identifies short AV intervals in ~67% of fetuses with postnatal WPW.
Why the study?
The study aimed to investigate whether Doppler interrogation of the superior vena cava and aorta in fetal echocardiograms could identify fetuses with Wolff-Parkinson-White syndrome.
Does atrioventricular interval measurement using the superior vena cava and aorta Doppler technique on fetal echocardiogram identify prenatal Wolff-Parkinson-White syndrome in fetuses presenting with tachyarrhythmias?
Cohort (n=9)
The assessor of the fetal echocardiogram report was blinded to the presence or absence of postnatal WPW
No
Does atrioventricular interval measurement using the superior vena cava and aorta Doppler technique on fetal echocardiogram identify prenatal Wolff-Parkinson-White syndrome in fetuses presenting with tachyarrhythmias?
Answers are grounded in this paper and cite their sources.
Doppler echocardiographic measurement of the atrioventricular interval using the SVC-Ao technique can prenatally identify Wolff-Parkinson-White syndrome in two-thirds of affected fetuses presenting with tachyarrhythmias, facilitating targeted perinatal arrhythmia management.
Background Fetal Doppler echocardiography has been widely used for the detection and characterization of fetal tachyarrhythmias. Doppler interrogation of the superior vena cava and the aorta (SVC-Ao) is used to determine the electrophysiological etiology of arrhythmias. The present study aims to investigate if the SVC-Ao technique in fetal echocardiograms could identify fetuses with Wolff-Parkinson-White (WPW) syndrome. Methods We retrospectively searched for consecutive fetal echocardiograms with evidence of tachyarrhythmias performed at the CHU Sainte-Justine from January 2000 to July 2021. The primary outcome was defined as the presence of pre-excitation on postnatal electrocardiogram (ECG) in the context of a prenatal tachyarrhythmia and the identification of a short atrioventricular (AV) interval. Results From a cohort of 69 patients presenting with fetal tachyarrhythmia diagnosed by echocardiography, AV intervals were measured in 9 fetuses (13%) that showed WPW on the postnatal surface ECG. The AV interval measured using fetal echocardiography showed a median of 107 ms (interquartile range: 104-116 ms), representing a z -score of –1.27 (–2.01 to –0.56). Six fetuses (67%) had repeated AV intervals ≤–2 standard deviation. Three (33%) had WPW on postnatal surface ECG but did not have short AV intervals on fetal echocardiograms, representing a false negative for the diagnostic yield of the technique. Conclusions Doppler echocardiographic AV interval measurements in fetuses with arrhythmias allow identification of prenatal WPW. The early diagnosis of WPW offers the possibility of a more comprehensive postnatal management plan, including the neonatology and cardiology teams, as well as preparing in advance for specific antiarrhythmic drug therapy.
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Veillette et al. (2024) conducted a cohort in Fetal tachyarrhythmia with postnatal Wolff-Parkinson-White (WPW) syndrome (n=9). Fetal Doppler echocardiography atrioventricular (AV) interval measurement using simultaneous interrogation of the superior vena cava and aorta (SVC-Ao technique) was evaluated on Presence of pre-excitation on baseline postnatal ECG in the context of a short AV interval (z-score <= -2.0) on fetal echocardiogram. Fetal Doppler SVC-Ao AV interval measurement identified short AV intervals (z-score <=-2 SD) in 67% (6/9) of fetuses with tachyarrhythmia and postnatally confirmed WPW syndrome.
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