Fetal Arrhythmias: Basics of Diagnosis
Transcript of Fetal Arrhythmias: Basics of Diagnosis
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11th Annual Fetal Echocardiography Symposium at UCLAFetal Arrhythmias: Basics of Diagnosis
Gary M Satou, MD FASE FAHADirector, Pediatric Echocardiography
Co-Director, Fetal Cardiology Program UCLA Mattel Children’s Hospital
UCLA David Geffen School of Medicine
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Fetal Arrhythmias…
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Heart Block Atrial Flutter
Been around a long time..
1983
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Technology/Evaluation: STIC M-Mode from 4D Volume
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Not Hard ! Basic Electrophysiology Simple Math (focus on mechanical AV relations) “Big Picture”- FHR regular? fast? slow? (AV ratio 1:1 ?) Usual ultrasound tools: 2D, M Mode, Pulse Doppler
11th Annual Fetal Echocardiography Symposium at UCLA
Fetal Arrhythmias: Basics of Diagnosis
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Fetal Arrhythmias: Basics of Diagnosis
Kevin and Jeremy
Best Advice..Ask the electrophysiologists..
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Fetal Arrhythmias: Basics of Diagnosis
Not just clips “Electrical-Physiologic” Correlation Ultrasound tools/modalities Sample Illustrations
11th Annual Fetal Echocardiography Symposium at UCLA
Overview
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Fetal Arrhythmias: Basics of Diagnosis
Anatomy
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PhysiologyElectrical Depolarization
Fetal Arrhythmias: Basics of Diagnosis
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Waveforms
Fetal Arrhythmias: Basics of Diagnosis
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Fetal Arrhythmias: Basics of Diagnosis
Ultrasound Tools/Modalities
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2 Dimensional Imaging
Sinus Tachycardia
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2 Dimensional Imaging
Vent Tachycardia
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M Mode
Ventricular Rate: 200 Atrial Rate: 400
Atrial Flutter (2:1)
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Color M-Mode
Blocked PACs
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Pulsed Wave Doppler
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Pulsed Wave Doppler
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Pulsed Wave Doppler SVC/Aorta
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Pulsed Wave Doppler
SVC/Aorta
MV/AoV
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Fetal Arrhythmias: Basics of Diagnosis
Optimize Image Resolution Zoom in/use Depth Speed (space things out!) Consider labeling
Important: No Matter what modality..
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Fetal Arrhythmias: Basics of Diagnosis
Sample Illustrations
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SR w 1:1 AV conduction
Fetal Arrhythmias: Basics of Diagnosis
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Fetal Arrhythmias: Basics of Diagnosis
SR w PACs
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SR w PACs
SR w PVCs
Fetal Arrhythmias: Basics of Diagnosis
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Fetal Arrhythmias: Basics of Diagnosis
SVT
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Fetal Arrhythmias: Basics of Diagnosis
SVT
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Fetal Arrhythmias: Basics of Diagnosis
3rd degree AVB
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Fetal Arrhythmias: Basics of Diagnosis
Atrial Flutter
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Nothing Magical - Be “simple” & think the “basics” Know: Electrical-Physiologic correlates Ultrasound Tools: 2D, Pulse Doppler, M Mode Big picture: regular? A:V ratio 1:1 ? Too fast? slow?
Fetal Arrhythmias: Basics of Diagnosis
11th Annual Fetal Echocardiography Symposium at UCLA
Best Advice: Ask Someone Else!
SUMMARY
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Thank You
11th Annual Fetal Echocardiography Symposium at UCLA