Feasibility of Non-invasive Fetal Electrocardiographic Interval Measurement in the Outpatient Clinical Setting

Doshi, Ashish N.; Mass, Paige; Cleary, Kevin; Moak, Jeffrey P.; Funamoto, Kiyoe; Kimura, Yoshitaka; Khandoker, Ahsan H.; Krishnan, Anita

doi:10.1007/s00246-019-02128-w

Cited by 12 publications

(10 citation statements)

References 22 publications

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“…New methods to assess fetal cardiac electrophysiology would therefore be useful. Recently, Doshi and colleagues 29 demonstrated the feasibility of prenatal ECG on 55 women and obtained interpretable results for 50 of them. However, this study did not include cases with tachyarrhythmia, making its ability to accurately characterize tachyarrhythmias speculative.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of sustained fetal tachyarrhythmias after transplacental treatment

et al. 2021

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Background Fetal tachyarrhythmia is a condition that may lead to cardiac dysfunction, hydrops, and death. Despite a transplacental treatment, failure to obtain or maintain sinus rhythm may occur. Objective We aimed to analyze the perinatal outcomes of sustained fetal tachyarrhythmias after in utero treatment. Methods We performed a retrospective evaluation of 69 cases with sustained fetal tachyarrhythmia. We compared the perinatal and long-term outcomes of prenatally converted and drug-resistant fetuses. Tachyarrhythmia subtypes were also evaluated. Results Conversion to sinus rhythm was obtained in 74% of cases; 26% of cases were drug-resistant and delivered arrhythmic. Three perinatal deaths occurred in both groups (6.7% vs 17%, P = .34). Neonates delivered arrhythmic were more frequently admitted to neonatal intensive care units (75% vs 31%, P < .01), and their hospital stay was longer (20.9 vs 6.64 days, P < .001). Multiple neonatal recurrences (81% vs 11%, P < .001), temporary hemodynamic dysfunction or heart failure (50% vs 6.7%, P < .001), and postnatal use of a combination treatment (44% vs 13%, P = .028) were also more frequent in this population. Beyond the neonatal period, rates of recurrences within the first 16 months were higher in drug-resistant fetuses (HR = 16.14, CI 95% [4.485; 193.8], P < .001). In this population, postnatal electrocardiogram revealed an overrepresentation of rare mechanisms, especially permanent junctional reciprocating tachycardia (PJRT) (31%). Conclusion Prenatal conversion to stable sinus rhythm is a major determinant of perinatal and long-term outcomes in fetal tachyarrhythmias. The underlying electrophysiological mechanisms have a major role in predicting these differential outcomes with an overrepresentation of PJRT in the drug-resistant population.

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Section: Discussionmentioning

confidence: 99%

Outcomes of sustained fetal tachyarrhythmias after transplacental treatment

et al. 2021

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“…Blind source separation with reference technique may offer a novel, noninvasive method for fECG that is portable and able to be acquired in a standard patient examination room and thus, more clinically accessible [18]. This is especially valuable in suspected congenital LQTS in which frequent evaluation of the fetal heart rate and rhythm is essential.…”

Section: Discussionmentioning

confidence: 99%

“…This case series highlights the use of a noninvasive 12-lead fetal ECG device with blind source separation with reference technique (IRIS TM ; Atom Medical Company, Tokyo, Japan) in the diagnosis and management of fetal LQTS. This case series is a part of an institutional review board-approved research protocol at our institution with this device from which early work has been published [18]. Table 1 summarizes the results of all 3 cases.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive Fetal Electrocardiography in the Diagnosis of Long QT Syndrome: A Case Series

et al. 2020

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“…The Institutional Review Boards (IRB: 2015-2-80-1) have approved the study protocols with appropriate institutional agreements. Abdominal signals with 12 channels were recorded for 10 min [12], and sampled using 16 bit resolution for 1 ms. The fetal ECG had been separated from the abdominal composite signal using maternal ECG cancellation in combination with blind source separation with a reference as reported in [13].…”

Section: Processing Of Participants Ecg Datasetmentioning

confidence: 99%

Employing Support Vector Machine Regression to Estimate the Fetal Gestational Age

Wahbah¹,

Sakaji²,

Funamoto³

et al. 2022

Computing in Cardiology Conference (CinC)

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The accurate estimation of the Gestational Age (GA) in fetal development studies has the potential to detect health issues at early stages of pregnancy. In this article, we adopt the Support Vector Machine (SVM) tool to investigate whether gold standard GA can be reliably estimated by using maternal as well as fetal Heart Rate Variability (HRV) features. The study considered Electrocardiogram (ECG) signals from 60 pregnant women. Maternal and fetal HRV parameters were calculated, and SVM regression with the linear kernel function was utilized to produce a robust estimate of fetal age. By evaluating the crossvalidation performances, we found that maternal electrophysiological parameters contribute to the correct estimation of the GA. Results showed that the linear kernel maintains better performance over the radial basis function kernel in the SVM-based regression models. Compared with gold standard GA identified by CRL, the proposed model resulted in an error of 5.11 weeks, Bland-Altman estimated bias of -0.31 weeks and limits of agreement of 8.97 and -9.59 weeks, and Pearson correlation coefficient of 0.63. It can be speculated that the fetal GA can be more reliably estimated when incorporating maternal along with fetal HRV parameters using 1 min of ECG signals.

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Feasibility of Non-invasive Fetal Electrocardiographic Interval Measurement in the Outpatient Clinical Setting

Cited by 12 publications

References 22 publications

Outcomes of sustained fetal tachyarrhythmias after transplacental treatment

Outcomes of sustained fetal tachyarrhythmias after transplacental treatment

Noninvasive Fetal Electrocardiography in the Diagnosis of Long QT Syndrome: A Case Series

Employing Support Vector Machine Regression to Estimate the Fetal Gestational Age

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