Abnormalities of the fetal heart rhythm: irregular rhythm and the most common fetal tachyarrhythmias

Yannaeva N.E., Bokeriya E.L.

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia

Abnormalities of the rhythm and conduction of the fetal heart are detected quite rarely, namely, in 1–5% of pregnancies, according to various authors. In more than 90% of cases, arrhythmias are short-term and single episodes that have little clinical significance. However, about 10% of all arrhythmias are potentially life-threatening to the fetus. The mechanisms of heart rhythm disorders can be divided into abnormalities in the generation and abnormalities in the electrical impulse conduction. Rhythm disorders caused by the SA node refer to arrhythmias when the sinus node operate at an unusually fast or slow speed, that is, sinus tachy- or bradyarrhythmias. Ectopic heart rhythms (extrasystoles) occur when the pacer shifts from the SA node to the latent pacer. Abnormal pulse propagation is the circular propagation of an impulse around additional pathways – re-entry (supraventricular tachycardia, atrial flutter) or a disorder in the conduction of the pulse through the conduction system of the heart (AV block). Fetal arrhythmias usually refer to an irregular rhythm with a normal fetal heart rate (HR), tachyarrhythmia, defined as heart rate >180 beats/min, and bradyarrhythmia, defined as heart rate<110 beats/min. Fetal tachyarrhythmias can be divided into sinus tachycardia, supraventricular tachycardia, ventricular tachycardia. Many cases of abnormal fetal heart rhythm are of minor clinical significance, however, prolonged tachyarrhythmias or arrhythmias with ventricular heart rate of more than 200 beats per minute often cause heart failure and hydrops fetalis.
Conclusion: Fetal arrhythmias are serious conditions that require treatment to prevent heart failure and fetal death. It is necessary to perform ultrasound examination of the fetal heart to understand the main mechanism of rhythm disorders, to study the effect of arrhythmia on cardiac function, as well as to monitor the condition of the fetus during antiarrhythmic treatment.

Authors’ contributions: Yannaeva N.E. – collection and processing of the material, writing the text; Bokeriya E.L. – developing the concept and design of the article, checking the article for the reliability of data and the correct interpretation of medical terms, editing.
Conflict of interests. The authors declare no conflict of interest.
Funding. The study was conducted without sponsorship.
For citation: Yannaeva N.E., Bokeriya E.L. Abnormalities of the fetal heart rhythm: irregular rhythm and the most common fetal tachyarrhythmias. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (11): 11-19 (in Russian)


abnormalities of fetal heart rhythm
fetal arrhythmias
mechanisms of abnormalities of fetal heart rhythm
atrial extrasystoles
ventricular extrasystoles
blocked atrial extrasystoles
fetal sinus tachycardia
supraventricular tachyarrhythmia
ventricular tachycardia
atrial flutter


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Received 07.07.2023

Accepted 13.10.2023

About the Authors

Natalia E. Yannaeva, PhD, ultrasound diagnostics doctor, Senior Researcher, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(495)438-22-92, +7(903)328-30-25, yannaeva@yandex.ru, 117997, Russia, Moscow, Ac. Oparin str., 4.
Ekaterina L. Bokeriya, Dr. Med. Sci., Professor, Department of Neonatology, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia; neonatologist, pediatric cardiologist, Leading Researcher, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(495)438-26-00, e-bockeria@mail.ru, https://orcid.org/0000-0002-8898-9612, 117997, Russia, Moscow, Ac. Oparin str., 4.
Corresponding author: Natalia E. Yannaeva, yannaeva@yandex.ru
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