| Autor: |
Sian Chivers, Caroline Ovadia, William Regan, Vita Zidere, Trisha Vigneswaran, Gurleen Sharland, Eric Rosenthal, Paul T. Seed, John M. Simpson, Catherine Williamson |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
Heart Rhythm. 20:596-606 |
| ISSN: |
1547-5271 |
| Popis: |
Fetal long-QT syndrome (LQTS) may present with sinus bradycardia, functional 2:1 atrioventricular block (2:1AVB), and ventricular arrhythmias (VT/TdP) and lead to fetal or postnatal death. We performed a systematic review and individual participant data meta-analysis of 83 studies reporting outcomes of 265 fetuses where suspected LQTS was confirmed postnatally and determined risk of adverse peri/postnatal outcomes using logistic, and stepwise logistic regression. A longer fetal QTc was more predictive of death than any other antenatal factor (ROC area under curve (AUC), 0·85 (95% confidence interval (CI) 0·66-1·00)); risk of death was significantly increased with fetal QTc greater than 600ms. Neither fetal heart rate nor heart rate z-score predicted death (ROC AUC 0·51 (95%CI 0·31-0·71) and 0·59 (95%CI 0·37-0·80), respectively). The combination of antenatal VT/TdP or functional 2:1AVB and a lack of family history of LQTS was also highly predictive of death (ROC AUC 0·82(95%CI 0·76 to 0·88). Our data provide clinical screening tools to enable prediction and intervention for fetuses with LQTS at risk of death. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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