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KMID : 0390320180280010047
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Chungbuk Medical Journal
2018 Volume.28 No. 1 p.47 ~ p.52
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Spontaneously resolved fetal atrial flutter : a Case Report
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Ji Il-Woon
Yeon Hyeon-Kyeong
Choi Jin-Young
Kyoung Kyu-Sang
Hong Seung-Hwa
Jeong Eun-Hwan
Kim Hak-Soon
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Abstract
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Little is known about the spontaneous initiation and termination patterns of atrial flutter. Fetal atrial flutter is most commonly generated within the atria themselves by an intra-atrial reentrant circuit. Atrial flutter is observed only during the third trimester, supporting the favored hypothesis of an atrial macroreentry as the underlying mechanism of fetal atrial flutter. The atrium probably is big enough for establishing a macroreentry circuit at about 27 to 30 weeks of gestation, associated with a high vulnerability against triggering atrial extrasystoles. The frequency of this atrial reentry tachycardia is between 350 and 500 beats/minute. The atrio-ventricular node, which is not part of the reentry circuit, usually protects the ventricles by variably blocking atrio-ventricular conduction, with the result of a substantially slower varying or fixed ventricular rate, depending on the degree of atrio-ventricular block, which may be a varying or fixed 2:1, 3:1, or 4:1 block. Here we report a case of fetal atrial flutter detected by the fetal tococardiography and fetal echocardiography and resolved before birth.
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KEYWORD
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Atrial flutter, Fetal, Ultrasound
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