{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:41Z","timestamp":1753876241785,"version":"3.41.2"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Congenital long QT syndrome (LQTS) type 1 is characterized by abnormally prolonged ventricular repolarization caused by inherited defects in cardiac potassium channels. Patients are predisposed to ventricular arrhythmias and even sudden cardiac death. In some cases, foetal sinus bradycardia is the only sign, making prenatal diagnosis challenging. Physicians should be aware of this subtle presentation of LQTS. Early diagnosis and proactive treatment are crucial for preventing unexpected cardiac events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A healthy and asymptomatic 25-year-old pregnant woman was referred to our institute for cardiac evaluation after persistent foetal sinus bradycardia was detected during repeated ultrasounds, despite the absence of any foetal morphological or functional cardiac anomalies. After a thorough assessment, the mother was diagnosed with LQTS type 1, as confirmed by molecular genetic testing. Appropriate management, including maternal medication and increased surveillance, was initiated. The infant was delivered safely, and his electrocardiogram revealed a significantly prolonged QTc interval. Genetic testing confirmed the maternally inherited variant in KCNQ1 gene, and beta-blocker therapy was started. No arrhythmic events were noted.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Detection and careful stratification of foetal heart rate (FHR) is crucial in every pregnancy. Foetal bradycardia can be caused by both maternal and foetal factors. Persistent low FHR should raise a high suspicion for LQTS. The condition may also present with atrioventricular blocks, torsades de pointes, or sudden intrauterine foetal demise. Accurate and early diagnosis of LQTS is essential for implementing appropriate management strategies, which include vigilant monitoring, effective medical treatment, careful planning of delivery, and post-natal care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae440","type":"journal-article","created":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T11:16:47Z","timestamp":1725189407000},"source":"Crossref","is-referenced-by-count":0,"title":["Low foetal heart rate, a potentially ominous finding: case report"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0318-734X","authenticated-orcid":false,"given":"Andreea Sorina","family":"Afana","sequence":"first","affiliation":[{"name":"Expert Center for Genetic Cardiovascular Diseases, Emergency Institute for Cardiovascular Diseases , 258 Fundeni Street, Bucharest 022328 ,","place":["Romania"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3824-1489","authenticated-orcid":false,"given":"Cristina","family":"Filip","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, University of Medicine and Pharmacy Carol Davila , 8 Eroii Sanitari Blv., Bucharest 050474 ,","place":["Romania"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9745-9891","authenticated-orcid":false,"given":"Brindusa","family":"Cimpoca","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Medicine and Pharmacy Carol Davila , 8 Eroii Sanitari Blv., Bucharest 050474 ,","place":["Romania"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0804-6690","authenticated-orcid":false,"given":"Ioana","family":"Dumitrascu-Biris","sequence":"additional","affiliation":[{"name":"Fetal Medicine Department, Filantropia Clinical Hospital , 11-13 Ion Mihalache Blv., Bucharest 011171 ,","place":["Romania"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3438-2612","authenticated-orcid":false,"given":"Ruxandra","family":"Jurcut","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Pathology, University of Medicine and Pharmacy Carol Davila , 8 Eroii Sanitari Blv., Bucharest 050474 ,","place":["Romania"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,9,1]]},"reference":[{"key":"2024093012035357900_ytae440-B1","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1097\/AOG.0b013e3182004fa9","article-title":"Practice bulletin no. 116: management of intrapartum fetal heart rate tracings","volume":"116","author":"American College of Obstetricians and Gynecologists","year":"2010","journal-title":"Obstet Gynecol"},{"key":"2024093012035357900_ytae440-B2","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1002\/uog.26224","article-title":"ISUOG practice guidelines (updated): fetal cardiac screening","volume":"61","author":"Carvalho","year":"2023","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2024093012035357900_ytae440-B3","doi-asserted-by":"crossref","first-page":"2688","DOI":"10.1161\/CIRCULATIONAHA.112.114132","article-title":"Fetal heart rate predictors of long QT syndrome","volume":"126","author":"Mitchell","year":"2012","journal-title":"Circulation"},{"key":"2024093012035357900_ytae440-B4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000339150","article-title":"Fetal presentation of long QT syndrome\u2014evaluation of prenatal risk factors: a systematic review","volume":"33","author":"Ishikawa","year":"2013","journal-title":"Fetal Diagn Ther"},{"key":"2024093012035357900_ytae440-B5","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1016\/j.hrthm.2022.12.026","article-title":"Systematic review of long QT syndrome identified during fetal life","volume":"20","author":"Chivers","year":"2023","journal-title":"Heart Rhythm"},{"key":"2024093012035357900_ytae440-B6","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1161\/CIRCRESAHA.110.224600","article-title":"Phenotypic manifestations of mutations in genes encoding subunits of cardiac potassium channels","volume":"109","author":"Shimizu","year":"2011","journal-title":"Circ Res"},{"key":"2024093012035357900_ytae440-B7","doi-asserted-by":"crossref","first-page":"2975","DOI":"10.1001\/jama.294.23.2975","article-title":"Genetic testing in the long QT syndrome","volume":"294","author":"Napolitano","year":"2005","journal-title":"JAMA"},{"key":"2024093012035357900_ytae440-B8","doi-asserted-by":"crossref","first-page":"e008082","DOI":"10.1161\/CIRCEP.119.008082","article-title":"Complex and novel arrhythmias precede stillbirth in fetuses with de novo long QT syndrome","volume":"13","author":"Strand","year":"2020","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2024093012035357900_ytae440-B9","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1016\/j.jacep.2020.06.001","article-title":"Genotype predicts outcomes in fetuses and neonates with severe congenital long QT syndrome","volume":"6","author":"Moore","year":"2020","journal-title":"JACC Clin Electrophysiol"},{"key":"2024093012035357900_ytae440-B10","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1161\/CIRCEP.113.000618","article-title":"Arrhythmia phenotype during fetal life suggests long-QT syndrome genotype: risk stratification of perinatal long-QT syndrome","volume":"6","author":"Cuneo","year":"2013","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2024093012035357900_ytae440-B11","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1016\/j.hrthm.2010.08.023","article-title":"Implantable cardioverter defibrillator therapy for congenital long QT syndrome: a single-center experience","volume":"7","author":"Horner","year":"2010","journal-title":"Heart Rhythm"},{"key":"2024093012035357900_ytae440-B12","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1016\/j.jacc.2006.09.054","article-title":"Long QT syndrome and pregnancy","volume":"49","author":"Seth","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"2024093012035357900_ytae440-B13","doi-asserted-by":"crossref","first-page":"3165","DOI":"10.1093\/eurheartj\/ehy340","article-title":"2018 ESC guidelines for the management of cardiovascular diseases during pregnancy","volume":"39","author":"Regitz-Zagrosek","year":"2018","journal-title":"Eur Heart J"},{"key":"2024093012035357900_ytae440-B14","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.3390\/medicina58111694","article-title":"Long QT syndrome management during and after pregnancy","volume":"58","author":"Marcinkeviciene","year":"2022","journal-title":"Medicina (B Aires)"},{"key":"2024093012035357900_ytae440-B15","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.hrthm.2019.08.004","article-title":"Caring for the pregnant woman with an inherited arrhythmia syndrome","volume":"17","author":"Roston","year":"2020","journal-title":"Heart Rhythm"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/9\/ytae440\/59450772\/ytae440.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/8\/9\/ytae440\/59450772\/ytae440.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T12:04:11Z","timestamp":1727697851000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytae440\/7745858"}},"subtitle":[],"editor":[{"given":"Christian","family":"Sohns","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Megha","family":"Agarwal","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,9,1]]},"references-count":15,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytae440","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2024,9]]},"published":{"date-parts":[[2024,9,1]]},"article-number":"ytae440"}}