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

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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.

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Fig. 1
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Abbreviations

AV:

Atrioventricular

AF:

Atrial flutter

BPM:

Beats per minute

EFE:

Endocardial fibroelastosis

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Authors and Affiliations

  1. Emory University School of Medicine, Atlanta, GA, 30307, USA

    Jeffrey H. Sacks, Cyrus Samai & Usama Kanaan

  2. Children’s Healthcare of Atlanta, Atlanta, GA, 30307, USA

    Jeffrey H. Sacks, Cyrus Samai & Usama Kanaan

  3. Atlanta Perinatal Consultants, Atlanta, GA, 30341, USA

    Kevin Gomez

  4. Sibley Heart Center, 2835 Brandywine Road, Suite 300, Atlanta, GA, 30341, USA

    Usama Kanaan

Authors
  1. Jeffrey H. Sacks
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  2. Cyrus Samai
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  3. Kevin Gomez
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  4. Usama Kanaan
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Correspondence to Usama Kanaan.

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Sacks, J.H., Samai, C., Gomez, K. et al. Maternal Antibody-Associated Fetal Second-Degree Heart Block and Atrial Flutter: Case Report and Review. Pediatr Cardiol 34, 2040–2043 (2013). https://doi.org/10.1007/s00246-012-0588-x

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  • DOI: https://doi.org/10.1007/s00246-012-0588-x

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