Profound fetal bradycardia: a case report highlighting treatment options.

A case report of a fetus that presented at 33 weeks gestation with profound bradycardia associated with ventricular rates of < 50 beats per minute. Possible management strategies include continued observation, medical intervention of the mother with stimulants and urgent delivery of the fetus. The differential diagnosis, management and ultimate course of this patient are discussed.

Malignant wide complex tachycardia after adenosine administration to a postoperative pediatric patient with congenital heart disease.

Adenosine has become the treatment of choice for paroxysmal supraventricular tachycardia because of its safety and efficacy. There have been no reports of malignant arrhythmias occurring after adenosine administration. This case report presents the occurrence of a malignant wide complex tachycardia after intravenous adenosine administration in a 10-year-old boy 2 days after a Fontan procedure.

Usefulness of intermittent monitoring of mixed venous oxygen saturation after stage I palliation for hypoplastic left heart syndrome.

Most deaths after stage I palliation for hypoplastic left heart syndrome have occurred within the first 24 hours after surgery. Efforts to improve 1-day survival should therefore have significant impact on improving overall survival. Early death has most often been attributed to low cardiac output and abnormalities of pulmonary to systemic flow ratio (Qp/Qs).

Use of adenosine in the management of perioperative arrhythmias in the pediatric cardiac intensive care unit.

Objective: To assess the safety, efficacy, and diagnostic usefulness of iv adenosine in treating acute episodes of paroxysmal supraventricular tachycardia in critically ill infants and children with congenital heart disease.

Design: A consecutive sample study over a 1-yr period.

Setting: A six-bed pediatric cardiac ICU at a tertiary care center.

Transesophageal echocardiographic guidance of balloon atrial septostomy.

Two newborn infants with transposition of the great vessels and an intact ventricular septum were cyanotic when they underwent bedside balloon atrial septostomy in the neonatal intensive care unit. The procedure was conducted under direct transesophageal two-dimensional echocardiographic guidance. Success of the procedure was evaluated with color flow Doppler and the two-dimensional assessment of the septostomy.