Objective: To assess diastolic ventricular function by establishing E/A ratio(in pulsed Doppler-PD) and Em/Am ratio(in Doppler tissue-DTI) in fetuses with SVT and AF after conversion to sinus rhythm.
Methods: We analyzed 15 fetuses with SVT and 4 with AF with transplacental antiarrhythmic treatment between 22 and 38 week’s gestation. All of them had conversion to sinus rhythm. E/A ratio was evaluated in 15 objects with SVT and 4 with AF and Em/Am ratio in 10 and 4 respectively. Examinations were performed using Sequoia 512, with transabdominal (3,5-6 MHz) and cardiological probe (2-5 MHz). Sample volumes were placed in the tricuspid valve (PD) and the basal part of RV (DTI) in the 4-chamber view.
Results: During early phase after conversion to sinus rhythm the E/A and Em/Am ratio was normal (<1) only in 2 fetuses with SVT. E/A ratio was abnormal (>1) in 13 fetuses with SVT and 4 with AF. Em/Am ratio was abnormal (>1) in 8 with SVT and 4 with AF. The normalization of E/A ratio took from 3 to 8 days, and Em/Am ratio – from 3 to 22 days.
Conclusions: To the best of our knowledge our observation is the first report of abnormal fetal E/A and Em/Am ratio at early recovery after drug-induced cardioversion of SVT and AF. The observed phenomenon may be caused by the transient improvement of ventricular diastolic function and myocardial blood flow, which returns to typical fetal features with individual differences. Further studies to confirm our observations are warranted.