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504 D. Maulik<br />

of the cardiac sarcolemmal membrane, suggesting a<br />

molecular mechanism for the pathogenesis of the<br />

heart block [53]. A high titer of anti-Ro antibody<br />

(> 1 :16) [54] and the concurrent presence of anti-La<br />

antibodies increase the risk of congenital heart block.<br />

Compared with other commonly encountered fetal<br />

arrhythmias, congenital heart block generally carries<br />

a substantially poorer prognosis, with an overall mortality<br />

ranging from 50% to 60% [55, 56]. The prognosis<br />

is worse when (1) fetal cardiac malformation is<br />

present; (2) the ventricular rate is

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