Case Report

Pediatric Cardiology

, Volume 34, Issue 8, pp 2040-2043

First online:

Maternal Antibody-Associated Fetal Second-Degree Heart Block and Atrial Flutter: Case Report and Review

  • Jeffrey H. SacksAffiliated withEmory University School of MedicineChildren’s Healthcare of Atlanta
  • , Cyrus SamaiAffiliated withEmory University School of MedicineChildren’s Healthcare of Atlanta
  • , Kevin GomezAffiliated withAtlanta Perinatal Consultants
  • , Usama KanaanAffiliated withEmory University School of MedicineChildren’s Healthcare of AtlantaSibley Heart Center Email author 

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Exposure to maternal anti-Ro (SS-A) and anti-La (SS-B) antibodies is a well-described risk factor for the development of fetal atrioventricular (AV) block. The role of maternal fluorinated steroids in the treatment and prevention of antibody-mediated fetal AV block is controversial. Fetal atrial flutter has rarely been described in association with maternal antibodies. This report describes a case of fetal exposure to maternal anti-Ro antibodies with associated second-degree AV block and atrial flutter. Interestingly, the reported patient had 2:1 AV conduction during both normal atrial rates (consistent with AV node conduction disease) and episodes of flutter (consistent with physiologic AV node functionality). The fetus was treated with transplacental digoxin and dexamethasone, which resolved both rhythm disturbances. The case report is followed by a brief discussion of AV block and atrial flutter associated with maternal antibody exposure.


Anti-La (SS-B) antibodies Anti-Ro (SS-A) antibodies Atrial flutter Fetal arrhythmia Heart block