Fetal ventricular tachycardia

A rare entity, fetal ventricular tachycardia presents with a rapid ventricular rate exceeding, and occurring independently from, the atrial rate.  The ventricular rate is typically over 180 beats per minute 1. Atrioventricular dissociation is characteristic; two separate pacemakers dictate the activity of the atria and ventricles, respectively. 

Epidemiology

Occurs in less than 2% of fetal tachydysrhythmia cases. Associated with:

Radiographic features

Antenatal ultrasound - echocardiography

Features on M-mode and pulsed wave Doppler (PWD) analysis of cardiac contraction patterns which support the diagnosis of ventricular tachycardia include 3:

  • rapid, regular ventricular activity
    • timing of ventricular depolarization may be accurately timed by the inward excursions of the ventricular walls (M-mode), or systolic V waves (PWD)
  • ventricular activity rate exceeds that of the atria
    • independent, dissociated activity of atria and ventricles
    • in rare instances, retrograde conduction from the ventricular pacemaker and (1:1) atrial capture may occur
    • the atrial rate will then closely approximate ventricular rate
      • utilization of tissue Doppler imaging may help elucidate the first structure which contracts 2
Congenital heart disease

There is more than one way to present the variety of congenital heart diseases. Whichever way they are categorized, it is helpful to have a working understanding of normal and fetal circulation, as well as an understanding of the segmental approach to imaging in congenital heart disease.

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Article information

rID: 67222
Synonyms or Alternate Spellings:
  • Fetal VT
  • FVT

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