Multicentre study of fetal cardiac time intervals using magnetocardiography

Stinstra, J.G.; Golbach, E.G.M.; Leeuwen, P. van; Lange, Silke; Menéndez, Theresa; Moshage, Werner; Schleußner, E; Kaehler, Christiane; Horigome, Hitoshi; Shigemitsu, S; Peters, M.J.

doi:10.1046/j.1471-0528.2002.01057.x

Cited by 106 publications

(56 citation statements)

References 20 publications

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“…These results mean that the vector fMCG is much less affected by fetal presentation and that it is possible to standardize the fMCG waveform and establish the normal values of fetal cardiac time intervals. The PR interval in uncomplicated fetuses was rather constant during the period of concern and a little shorter than what we reported previously (9,11). This is possibly due to the limited detection area covered by the four-channel SQUID system, resulting in failure of the sensors to register at those sites where the p wave is the predominant feature.…”

Section: Discussioncontrasting

confidence: 51%

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Standardization of the PQRST Waveform and Analysis of Arrhythmias in the Fetus Using Vector Magnetocardiography

et al. 2006

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Fetal magnetocardiography (fMCG) is useful for analysis of fetal cardiac events. However, fetal presentation and movement affect the fMCG waveform, making it difficult to standardize the waveform. The aim of this study was to investigate whether the use of vector magnetometers can compensate for these limitations. We studied 59 fetuses (gestational age, 22-40 wk, median, 32), including 41 with uncomplicated pregnancies and 18 with fetal cardiac disease. fMCG was recorded twice in each case, and the two waveforms were compared with each other in uncomplicated subjects to investigate the effects of fetal presentation. The superconducting quantum interference device (SQUID) system used in this study was a 12-channel vector magnetometer, by which the three components of the magnetic field (Bx, By, Bz) could be detected simultaneously at four recording points. By constructing the three components, a composite waveform (Bxyz) was obtained. The configuration of the composite waveforms was similar among normal fetuses always with positive polarity, independent of fetal presentation and movement. The difference in the time intervals (PR, QRS, and ventricular activation time [VAT]) between the first and second measurements was minimal in the composite waveforms (Bxyz) compared with that in each channel (Bx, By, Bz). Even before signal averaging, waveforms with high time resolution were recorded in at least one of the three components, making it possible to analyze fetal arrhythmias precisely. Our results indicate that vector magnetocardiography is potentially useful for standardization of the fMCG waveforms and to provide a more complete and accurate analysis of fetal arrhythmias. fMCG has gathered increasing interest in recent years, particularly its potential clinical application (1-5). fMCG has an advantage over fetal electrocardiography recorded on the maternal abdomen in detecting fetal heart signals because magnetic fields are far less insulated by vernix caseosa and less interfered by maternal signals (6). fMCG may also be advantageous to fetal echocardiography for precise analysis of arrhythmias because it reflects the electric not mechanical properties of the heart (3), although the latter is a more prevalent and valuable method with relevant time resolution. Several studies have already reported the usefulness of fMCG in the diagnosis and management of fetal arrhythmias (5,7). Since fMCG provides detailed diagnosis of fetal arrhythmias, it is feasible to administer antiarrhythmic agents transplacentally based on accurate fMCG-based diagnosis (5,7,8).One disadvantage of the fMCG waveforms is their tendency to be largely affected by fetal orientation and movement, making it difficult to compare the waveforms among fetuses in various presentations. fMCG waveforms even fluctuate during measurement in the same fetus. Furthermore, fMCG data somewhat vary depending on the superconducting quantum interference device (SQUID) system used and the protocol of data acquisition (9). Nevertheless, the magnetic field ...

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Section: Discussioncontrasting

confidence: 51%

“…fMCG waveforms even fluctuate during measurement in the same fetus. Furthermore, fMCG data somewhat vary depending on the superconducting quantum interference device (SQUID) system used and the protocol of data acquisition (9). Nevertheless, the magnetic field is a vector and three components (Bx, By, Bz) can be measured individually and composed.…”

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confidence: 99%

Standardization of the PQRST Waveform and Analysis of Arrhythmias in the Fetus Using Vector Magnetocardiography

et al. 2006

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“…O n the basis of both electrocardiographic and magnetocardiographic measurements, the durations of fetal cardiac time intervals have been successfully assessed in the course of pregnancy (1)(2)(3)(4). Most studies have described a prolongation of atrial and ventricular depolarization times with advancing gestational age, and this has generally been attributed to overall growth and the concomitant increase in fetal cardiac muscle mass (4,5), based on the following rationale.…”

mentioning

confidence: 99%

“…Most studies have described a prolongation of atrial and ventricular depolarization times with advancing gestational age, and this has generally been attributed to overall growth and the concomitant increase in fetal cardiac muscle mass (4,5), based on the following rationale. The augmentation in the mass and dimensions of the fetal heart during the second and third trimester has been quantified on the basis of ultrasound recordings (6,7).…”

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confidence: 99%

Gender-Related Changes in Magnetocardiographically Determined Fetal Cardiac Time Intervals in Intrauterine Growth Retardation

et al. 2006

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Prenatal growth deficiencies as well as gender have been associated with cardiovascular disease in later life. It is also known that the duration of fetal cardiac time intervals (CTI) are dependent on fetal development. The aim of this work was to examine the relationship between fetal CTI in healthy and intrauterine growth retardation (IUGR) fetuses, taking gender into account. A total of 269 magnetocardiograms (MCG) were obtained in 47 healthy and 27 IUGR pregnancies. In each signal-averaged MCG, durations of CTI were determined. Age-and heart rate-corrected values were compared between normal and IUGR fetuses separately with respect to gender. Overall, there was an association between atrial and ventricular conduction times and estimated fetal body weight. In female fetuses, IUGR was associated with shorter P WAVE, PQ segment, PR interval, and QRS complex and longer STT and QT intervals. For males, this was so only for P wave, QRS complex, and STT interval. The shortening of conduction times in IUGR may be explained by reduced cardiac muscle mass associated with lower body weight. On the other hand, the gender-specific differences, particularly in the IUGR fetuses may be due to hormonal factors.

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“…44 with multichannel recordings. Recent reports provide further evidence conforming MCGs as a practical useful tool for supplemental information in addition to other diagnostic modalities including ECGs (17)(18)(19)(20), so as to best take care of patients.…”

Section: Introductionmentioning

confidence: 92%

Magnetocardiograms in Clinical Medicine: Unique Information on Cardiac Ischemia, Arrhythmias, and Fetal Diagnosis

Yamada

Yamaguchi

2005

Intern. Med.

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Cardiac diseases are the leading cause of death in population. Diagnostic tests to detect cardiac dysfunction at an early stage of the disease are desirable. The major focus has been centered on tests evaluating the perfusion of the heart with imaging techniques or detecting alterations in electrical or mechanical function of the heart. The heart generates magnetic fields that can be detected by body surface mapping utilizing super conducting quantum interference device sensors giving magnetocardiograms (MCGs). The advantages of MCG over traditional electrocardiograms (ECGs) are increased sensitivity to small signals and lack of conductivity in body tissues, presentation of direct component signals and primary currents. This review will highlight the basic principles and recent advantages of MCGs, and the application of MCG in clinical diagnosis, especially in cases whose ECGs are non-diagnostic or not specific, such as detecting baseline shift in ischemic heart disease, noninvasive His potential recording, detection of arrhythmic mechanism defining reentrant circuits vs non reentrant mechanism, diagnosis of fetal arrhythmias and prolongation of QT interval. Areas of future basic and clinical research are also discussed. (Internal Medicine 44: 1-19, 2005)

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Multicentre study of fetal cardiac time intervals using magnetocardiography

Cited by 106 publications

References 20 publications

Standardization of the PQRST Waveform and Analysis of Arrhythmias in the Fetus Using Vector Magnetocardiography

Standardization of the PQRST Waveform and Analysis of Arrhythmias in the Fetus Using Vector Magnetocardiography

Gender-Related Changes in Magnetocardiographically Determined Fetal Cardiac Time Intervals in Intrauterine Growth Retardation

Magnetocardiograms in Clinical Medicine: Unique Information on Cardiac Ischemia, Arrhythmias, and Fetal Diagnosis

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