{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:43:56Z","timestamp":1787503436398,"version":"build-2736575974"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,6,13]]},"abstract":"\n Background<\/jats:title>\n \n Atrial flutter (\n AF<\/jats:styled-content>\n l) accounts for up to one third of all fetal tachyarrhythmias and can result in premature delivery, hydrops, and fetal death in 10% of cases; however, the electrophysiology of\n AF<\/jats:styled-content>\n l in utero is virtually unstudied.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n In this observational study, we reviewed 19 fetal magnetocardiography studies from 16 fetuses: 15 fetuses (21\u201338\u00a0weeks\u2019 gestation) referred with an echocardiographic diagnosis of\n AF<\/jats:styled-content>\n l and 1 fetus (20\u00a0weeks\u2019 gestation) referred with a diagnosis of tachycardia that was shown by fetal magnetocardiography to have transient\n AF<\/jats:styled-content>\n l in addition to atrioventricular reciprocating tachycardia. Thirteen fetuses showed\n AF<\/jats:styled-content>\n l during the fetal magnetocardiography session, including 4 that presented prior to the third trimester. Five fetuses had incessant\n AF<\/jats:styled-content>\n l; all but 1 of the others with\n AF<\/jats:styled-content>\n l showed additional significant rhythms. Specifically,\n AF<\/jats:styled-content>\n l showed a strong association with rhythms involving an accessory pathway: atrioventricular reciprocating tachycardia, blocked reentrant premature atrial contractions, and ventricular preexcitation. The observed initiations and terminations of\n AF<\/jats:styled-content>\n l most often involved reentrant premature atrial contractions. Spontaneous termination of\n AF<\/jats:styled-content>\n l showed\n AF<\/jats:styled-content>\n l cycle length oscillations. Nine fetuses with 2:1\n AF<\/jats:styled-content>\n l also showed periods of 4:1 conduction or variable conduction that oscillated between 2:1 and 4:1; however, 3:1\n AF<\/jats:styled-content>\n l was relatively rare.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Fetal\n AF<\/jats:styled-content>\n l can occur as early as midgestation and is often accompanied by atrioventricular reciprocating tachycardia and other rhythms associated with an accessory pathway. The findings depict critical differences in the electrophysiology of\n AF<\/jats:styled-content>\n l in the fetus versus the neonate.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.003673","type":"journal-article","created":{"date-parts":[[2016,6,15]],"date-time":"2016-06-15T09:25:18Z","timestamp":1465982718000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Fetal Atrial Flutter: Electrophysiology and Associations With Rhythms Involving an Accessory Pathway"],"prefix":"10.1161","volume":"5","author":[{"given":"Annette","family":"Wacker\u2010Gussmann","sequence":"first","affiliation":[{"name":"Faculty of Sport and Health Sciences, Institute of Preventive Pediatrics, Munich, Germany"},{"name":"Department of Pediatric Cardiology and Congenital Heart Defects, German Heart Center, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janette F.","family":"Strasburger","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharda","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, University of Wisconsin\u2010Madison, Madison, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina F.","family":"Cuneo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The Heart Institute, Children's Hospital Colorado, Aurora, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Lutter","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, University of Wisconsin\u2010Madison, Madison, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald T.","family":"Wakai","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, University of Wisconsin\u2010Madison, Madison, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)00779-4"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/heart.89.8.913"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.026120"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(98)70455-X"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1996.tb00473.x"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)90122-8"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2011.2131141"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000043801.92580.79"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.04.020"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.297.6641.107"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(87)90823-X"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.67.1.80"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(96)00054-X"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.88.4.1866"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00589-6"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.79.6.576"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12576"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.01.388"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000109494.05317.58"},{"key":"e_1_3_3_21_2","first-page":"714","article-title":"Amiodarone given by three routes to terminate fetal atrial flutter associated with severe hydrops","volume":"82","author":"Flack NJ","year":"1993","unstructured":"Flack NJ, Zosmer N, Bennett PR, Vaughan J, Fisk NM. 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Obstet Gynecol. 1993;82:714\u2013716.","journal-title":"Obstet Gynecol"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437597.44550.5d"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.116.003673","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:52:31Z","timestamp":1715583151000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.116.003673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6,13]]},"references-count":21,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016,6,13]]}},"alternative-id":["10.1161\/JAHA.116.003673"],"URL":"https:\/\/doi.org\/10.1161\/jaha.116.003673","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,6,13]]},"assertion":[{"value":"2016-04-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-05-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-06-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e003673"}}