Noninvasive antepartum recording of fetal S-T segment with a newly developed 151-channel magnetic sensor system

Lowery, Curtis L.; Campbell, J. Quaid; Wilson, James D.; Murphy, P.; Preißl, Hubert; Malak, Sharp F.; Eswaran, Hari

doi:10.1067/mob.2003.367

Cited by 47 publications

(57 citation statements)

References 18 publications

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“…339 The fMCG captures the P wave, PR interval, QRS interval, ST-T waves, QT interval, and RR interval in most fetuses of >24 weeks' gestation and QRS and RR intervals in fetuses of >17 weeks' gestation. [340][341][342][343] With the use of fMCG, normative data for cardiac intervals, including gender-based intervals and those in multiple pregnancies, have been establis hed. 340,341,344,345 Compared with mechanical PR intervals derived from fetal pulsed Doppler, fMCG PR intervals were shorter than those obtained by pulsed Doppler.…”

Section: Fetal Magnetocardiographymentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

1,020

543

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Background— The goal of this statement is to review available literature and to put forth a scientific statement on the current practice of fetal cardiac medicine, including the diagnosis and management of fetal cardiovascular disease. Methods and Results— A writing group appointed by the American Heart Association reviewed the available literature pertaining to topics relevant to fetal cardiac medicine, including the diagnosis of congenital heart disease and arrhythmias, assessment of cardiac function and the cardiovascular system, and available treatment options. The American College of Cardiology/American Heart Association classification of recommendations and level of evidence for practice guidelines were applied to the current practice of fetal cardiac medicine. Recommendations relating to the specifics of fetal diagnosis, including the timing of referral for study, indications for referral, and experience suggested for performance and interpretation of studies, are presented. The components of a fetal echocardiogram are described in detail, including descriptions of the assessment of cardiac anatomy, cardiac function, and rhythm. Complementary modalities for fetal cardiac assessment are reviewed, including the use of advanced ultrasound techniques, fetal magnetic resonance imaging, and fetal magnetocardiography and electrocardiography for rhythm assessment. Models for parental counseling and a discussion of parental stress and depression assessments are reviewed. Available fetal therapies, including medical management for arrhythmias or heart failure and closed or open intervention for diseases affecting the cardiovascular system such as twin–twin transfusion syndrome, lung masses, and vascular tumors, are highlighted. Catheter-based intervention strategies to prevent the progression of disease in utero are also discussed. Recommendations for delivery planning strategies for fetuses with congenital heart disease including models based on classification of disease severity and delivery room treatment will be highlighted. Outcome assessment is reviewed to show the benefit of prenatal diagnosis and management as they affect outcome for babies with congenital heart disease. Conclusions— Fetal cardiac medicine has evolved considerably over the past 2 decades, predominantly in response to advances in imaging technology and innovations in therapies. The diagnosis of cardiac disease in the fetus is mostly made with ultrasound; however, new technologies, including 3- and 4-dimensional echocardiography, magnetic resonance imaging, and fetal electrocardiography and magnetocardiography, are available. Medical and interventional treatments for select diseases and strategies for delivery room care enable stabilization of high-risk fetuses and contribute to improved outcomes. This statement highlights what is currently known and recommended on the basis of evidence and experience in the rapidly advancing and highly specialized field of fetal cardiac care.

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Section: Fetal Magnetocardiographymentioning

confidence: 99%

Diagnosis and Treatment of Fetal Cardiac Disease

Donofrio¹,

Moon-Grady²,

Hornberger³

et al. 2014

Circulation

1,020

543

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“…To overcome these challenges, two approaches were implemented: fi rst, improved signal detection algorithms were developed and applied [4,11] and, second, fetal magnetographic systems were developed that were dedicated to obstetrical assessment. The fi rst unique biomagnetic device for fetal investigations was the SARA (Squid Array for Reproductive Assessment) system, and it was shown that fMCG recordings with increased detection of the former, hardly recognizable T waves were achievable [18] . Based on this prototype, we developed a second generation device with a slightly higher number of sensors, a different sensor confi guration and a higher sampling rate of the signals (Figure 1 ).…”

Section: Introductionmentioning

confidence: 99%

Fetal magnetocardiography (fMCG): moving forward in the establishment of clinical reference data by advanced biomagnetic instrumentation and analysis

Kiefer-Schmidt¹,

Lim²,

Wacker-Gußmann³

et al. 2012

Journal of Perinatal Medicine

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Cardiotocography and echocardiography are currently standard for fetal heart monitoring. However, both do not provide adequate temporal resolution to measure fetal cardiac time intervals and detect arrhythmias, which can occur during normal sinus rhythm. Fetal magnetocardiography (fMCG) is a non-invasive technique measuring magnetic signals generated by fetal heart activity. Most fMCG devices are installed in research institutions limiting the implementation of this method in a clinical setting. Several institutions made a step forward by installing devices, in particular for fetal investigations, in hospital sites to evaluate the clinical benefit. Based on instrumentation differences which can affect signal quality, there is still no established reference database for fetal cardiac time intervals. A new magnetograph dedicated to fetal recordings was implemented with improved patient comfort. The setting was optimized to establish a standard. A total of 103 healthy fetuses starting as early as possible after the first trimester were recorded and fMCG values of cardiac time intervals were compared to former studies. Data allowed high and reliable detection for all fMCG components starting at 17 weeks. The data were comparable to fMCG multicenter studies, fetal electrocardiography and neonatal ECG results and could serve as a database of norm values for further investigation of fetal arrhythmias.

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“…The separation of fetal magnetocardiographic traces and the monitoring of fetal cardiac rhythms will allow extending to twin pregnancy all the possible clinical indications for fMCG, first of all the characterization of fetal arrhythmias (van Leeuwen et al 1999, Wakai et al 2000, 2003, Kandori et al 2003, Menendez et al 2001, Hosono et al 2002, Quartero et al 2002, Comani et al 2004a, but also situations still under evaluation, such as fetal intra-uterine growth retardation (Grimm et al 2003), cardiac hypertrophy in the fetus of diabetic mother (Horigome et al 2001), congenital heart defects (Kahler et al 2002) and monitoring of fetal oxygenation during labor (Lowery et al 2003).…”

Section: Discussionmentioning

confidence: 99%

“…Although various groups have reported on dependable fetal signal extraction in singleton pregnancy (van Leeuwen et al 1999, Wakai et al 2000, 2003, Kandori et al 2003, Menendez et al 2001, Hosono et al 2002, Quartero et al 2002, Comani et al 2004a, 2004b, 2004d, 2004e, Grimm et al 2003, Horigome et al 2001, Kahler et al 2002, Lowery et al 2003, Peters et al 2001, only one case of successful separation of fetal magnetocardiographic signals in twin pregnancy has been reported until present; fMCG was recorded using two distinct MCG sensor arrays positioned over the abdominal projections of the twins' hearts previously obtained with ultrasound examination, and the fetal traces were averaged in time before being analyzed (Costa Monteiro et al 2001).…”

Section: Introductionmentioning

confidence: 99%

Simultaneous monitoring of separate fetal magnetocardiographic signals in twin pregnancy

et al. 2005

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Fetal magnetocardiography (fMCG) allows the non-invasive recording of fetal cardiac electrical activity with increasing efficacy as gestation progresses. Many reports on the successful extraction of reliable fetal magnetocardiographic traces in singleton pregnancies exist in the literature, whereas there is only one report on the reconstruction of averaged fetal cardiac signals obtained in a twin pregnancy with the use of a double sensor array system. In this paper, we aimed at assessing the effectiveness of an ICA-based procedure to reconstruct the time course of fetal cardiac signals recorded with a single-shot multi-channel fMCG device in an uncomplicated twin pregnancy at 27 weeks. The evaluation of heart rate and beats synchronicity permitted the differentiation of fetal components; the quality of reconstructed fetal signals allowed visual inspection on single cycles and the simultaneous monitoring of separate fetal heart rate patterns. The proposed technique might be applied in twin pregnancies not only to characterize fetal arrhythmias, but also in all cases of discordant fetal growth, either in the case of intra-uterine growth retardation affecting one fetus, or in the case of twin-twin transfusion syndrome, a lifethreatening condition where both fetuses are at risk of heart failure.

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Noninvasive antepartum recording of fetal S-T segment with a newly developed 151-channel magnetic sensor system

Cited by 47 publications

References 18 publications

Diagnosis and Treatment of Fetal Cardiac Disease

Diagnosis and Treatment of Fetal Cardiac Disease

Fetal magnetocardiography (fMCG): moving forward in the establishment of clinical reference data by advanced biomagnetic instrumentation and analysis

Simultaneous monitoring of separate fetal magnetocardiographic signals in twin pregnancy

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