EP04.08: Two cases of fetal premature atrial contraction with cardiac dysfunction

Abstract

The majority of fetal arrhythmias involve premature contraction and they typically have good prognosis when uncomplicated by cardiac abnormalities. Although most premature contractions disappear, some may continue after birth. We experienced two cases of fetal arrhythmia with cardiac dysfunction. Case 1 was diagnosed with premature atrial contraction (PAC) at 34 weeks gestation. Fetal cardiac function was mainly assessed by the Doppler Tei index. The fetus was complicated with cardiomegaly and cardiac dysfunction. Tei indices of the right and left ventricles were 0.43 and 0.50. PAC disappeared at 37 weeks gestation, although cardiac function was not improved, with Tei indices of the right and left ventricles of 0.47 and 0.57. However, at 38 weeks gestation the cardiac function was improved, with Tei indices of the right and left ventricles of 0.21 and 0.20. The infant was delivered at 38 weeks gestation, with normal cardiac function and no arrhythmia as evaluated by ultrasonography. Case 2 was diagnosed with PAC at 22 weeks gestation. Fetal heart size and fetal cardiac function were normal, with a Tei index of the left ventricle of 0.28 (right ventricle not assessed). Fetal arrhythmia was decreased at 24 weeks gestation, although the fetus was complicated with cardiomegaly and cardiac dysfunction, with Tei indices of the right and left ventricles of 0.60 and 0.57. However, at 25 weeks gestation the cardiac function was improved, with Tei indices of the right and left ventricles of 0.48 and 0.42. This case is still pregnant continues. In summary, we presented two cases of PAC with cardiac dysfunction. Both cases had been subsequently developed cardiac dysfunction a few weeks after diagnosis of PAC. PAC has a good prognosis, although careful observation is required in cases with cardiac dysfunction.