Free Access
Fetal Diagn Ther 2008;24:282–285

Magnetocardiography-Guided Management of an Unusual Case of Isoimmune Complete Atrioventricular Block Complicated by Ventricular Tachycardia

Das B.a · Cuneo B.F.b · Ovadia M.b · Strasburger J.F.c · Johnsrude C.a · Wakai R.T.d
aDepartment of Pediatrics, Division of Pediatric Cardiology, University of Louisville, Louisville, Ky., bThe Heart Institute of Children, University of Illinois at Chicago School of Medicine, Chicago, Ill., cDepartment of Pediatrics, Division of Pediatric Cardiology, Medical College of Wisconsin, Milwaukee, Wisc., and dDepartment of Medical Physics, University of Wisconsin Madison, Madison, Wisc., USA
email Corresponding Author

 goto top of outline Key Words

  • Arrhythmia
  • AV block
  • Magnetocardiography

 goto top of outline Abstract

A fetus who was diagnosed at 25 weeks of gestation with isoimmune AV block presented at 34 weeks with a precipitous fall in ventricular rate and periods of tachycardia. Magnetocardiography revealed the tachycardia to be ventricular. After delivery, nonsustained ventricular tachycardia continued. The baby then successfully paced, and at higher ventricular rates the tachycardia resolved. Five years later the child has normal ventricular function and is doing well.

Copyright © 2008 S. Karger AG, Basel

 goto top of outline References
  1. Wakai RT, Leuthold AC, Cripe L, Martin CB: Assessment of fetal rhythm in complete congenital heart block by magnetocardiography. PACE 2000;23:1047–1050.
  2. Wakai TR, Leuthold AC, Martin CB: Atrial and ventricular fetal heart rate patterns in isolated congenital complete heart block detected by magnetocardiography. Am J Obstet Gynecol 1998;179:258–260.
  3. Mendez T, Achenbach S, Beinder E, Hofbeck M, Klinghammer L, Singer H, Moshage W, Daniel WG: Usefulness of magnetocardiography for the investigation of fetal arrhythmias. Am J Cardiol 2001;88:334–836.
  4. Wakai RT, Strasburger JF, Li Z, Deal BJ, Gotteiner NL: Magnetocardiographic rhythm patterns at initiation and termination of fetal supraventricular tachycardia. Circulation 2003;107:307–312.
  5. Cuneo BF, Ovadia M, Strasburger JF, et al: Prenatal diagnosis and in utero treatment of torsades de pointes associated with congenital long QT syndrome. Am J Cardiol 2003;91:1395–1398.
  6. Costedoat-Chalumeau N, Georgin-Lavialle S, Amoura Z, Piette JC: Anti-SSA/Ro and anti-SSB/La antibody-mediated congenital heart block. Lupus 2005;14:660–664.
  7. Cuneo BF, Strasburger JF, Wakai RT, Ovadia M: Conduction system disease in fetuses evaluated for irregular cardiac rhythm. Fetal Diagn Ther 2006;21:307–313.
  8. Dubin AM, Cuneo BF, Strasburger JF, Wakai RT, Van Hare GF, Rosenthal DN: Congenital junctional ectopic tachycardia and congenital complete atrioventricular block: a shared etiology? Heart Rhythm 2005;2:313–315.
  9. Jaeggi ET, Hamilton RM, Silverman ED, Zamora SA, Hornberger LK: Outcome of children with fetal, neonatal or childhood diagnosis of isolated congenital atrioventricular block. J Am Coll Cardiol 2002;39:130–137.
  10. Nield LE, Silverman ED, Taylor GP, et al: Maternal anti-Ro and anti-La antibody-associated endocardial fibroelastosis. Circulation 2002;105:843–848.
  11. Udink ten Cate FE, Breur JM, Cohen MI, et al: Dilated cardiomyopathy in isolated congenital complete atrioventricular block: early and long-term risk in children. J Am Coll Cardiol 2001;37:1129–1134.
  12. Lida M, Inamura N, Takeuchi M: Newborn infant with maternal anti-SSA antibody-induced complete heart block accompanying cardiomyopathy. Circulation J 2006;70:147–149.
  13. Zhao H, Cuneo B, Strasburger J, et al: Electrophysiological characteristics of fetal AV block. JACC 2008;91:77–84.
  14. Rein AJJT, O’Donnell C, Geva T, et al: Use of tissue velocity imaging in the diagnosis of fetal cardiac arrhythmias. Circulation 2002;106:1827–1833.
  15. Stinstra JG, Peters MJ: The influence of fetoabdominal tissues on fetal ECGs and MCGs. Arch Physiol Biochem 2002;110:165–176.

 goto top of outline Author Contacts

Bettina Cuneo, MD
The Heart Institute for Children, Hope Children’s Hospital
4440 W. 95th Street
Oak Lawn, IL 60645 (USA)
Tel. +1 708 684 580, Fax +1 708 648 4068, E Mail

 goto top of outline Article Information

This research was supported by NIH grants R01HL63174 (R.T.W.) and R21H0049022 (J.F.S.).

Received: June 25, 2007
Accepted after revision: September 7, 2007
Published online: September 2, 2008
Number of Print Pages : 4
Number of Figures : 3, Number of Tables : 1, Number of References : 15

 goto top of outline Publication Details

Fetal Diagnosis and Therapy (Clinical Advances and Basic Research)

Vol. 24, No. 3, Year 2008 (Cover Date: October 2008)

Journal Editor: Holzgreve W. (Basel), Evans M.I. (New York, N.Y.), Uzan S. (Paris), Michejda M. (Washington, D.C.), Pringle K.C. (Wellington)
ISSN: 1015–3837 (Print), eISSN: 1421–9964 (Online)

For additional information:

Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.