Pediatric Cardiology

, Volume 34, Issue 8, pp 2040–2043

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

  • Jeffrey H. Sacks
  • Cyrus Samai
  • Kevin Gomez
  • Usama Kanaan
Case Report

DOI: 10.1007/s00246-012-0588-x

Cite this article as:
Sacks, J.H., Samai, C., Gomez, K. et al. Pediatr Cardiol (2013) 34: 2040. doi:10.1007/s00246-012-0588-x

Abstract

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.

Keywords

Anti-La (SS-B) antibodiesAnti-Ro (SS-A) antibodiesAtrial flutterFetal arrhythmiaHeart block

Abbreviations

AV

Atrioventricular

AF

Atrial flutter

BPM

Beats per minute

EFE

Endocardial fibroelastosis

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Jeffrey H. Sacks
    • 1
    • 2
  • Cyrus Samai
    • 1
    • 2
  • Kevin Gomez
    • 3
  • Usama Kanaan
    • 1
    • 2
    • 4
  1. 1.Emory University School of MedicineAtlantaUSA
  2. 2.Children’s Healthcare of AtlantaAtlantaUSA
  3. 3.Atlanta Perinatal ConsultantsAtlantaUSA
  4. 4.Sibley Heart CenterAtlantaUSA