The Coincidence of Fetal Magnetocardiography and Direct Electrocardiography in a Case of Fetal Atrial Flutter due to Intracardiac Tumor

Hosono, Takayoshi; Kanagawa, Takeshi; Chiba, Yoshihide; Kandori, Akihiko; Tsukada, Keiji

doi:10.1159/000065379

Cited by 15 publications

(12 citation statements)

References 16 publications

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“…particular during the second half of gestation (2,3). FMCG is preferable to trans-abdominal fetal electrocardiogram (fECG), because it is almost unaffected by the insulating properties of vernix caseosa (4), and it was proved to provide, after adequate postprocessing, a trace coincident with fECG measured with scalp electrodes during labor, allowing precise identification of the onset and offset of P, QRS, and T waves and therefore enabling the quantification of fetal cardiac time intervals (fCTI) (5). For this reason, fMCG has been used in several clinical situations, such as fetal arrhythmias (6)(7)(8)(9), congenital heart defects (10), growth-restricted fetuses (11), cardiac hypertrophy in fetuses of diabetic mothers (12), and fetal hypoxia (13).…”

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confidence: 99%

Beat-to-beat estimate of fetal cardiac time intervals using magnetocardiography: longitudinal charts of normality ranges and individual trends

Comani

Liberati

Mantini

et al. 2005

Acta Obstet Gynecol Scand

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Background. Fetal magnetocardiography (fMCG) records fetal cardiac electro-physiological activity during the second half of gestation. We aimed at assessing normality values, related variability, and trends of fetal cardiac time intervals (fCTI) evaluated longitudinally from beat-to-beat fMCG analysis in uncomplicated pregnancies. Materials and methods. The fMCG were recorded with multi-channel system in shielded room. FCTI were estimated on more than 2600 fetal cardiac cycles from 51 fMCG data sets of uncomplicated pregnancies. Independent component analysis (ICA) allowed reconstructing reliable fetal signals for beat-to-beat identification of fCTI (RR, P wave, PQ, PR, QT, QTc, QRS, ST, and T wave); intra-individual variability analysis and trends were calculated; reference longitudinal charts accounted for intra-and interindividual variations and were compared with figures estimated on averaged signals. Results. For each data set, fCTI were calculated beat-to-beat on rhythm strips of more than 50 beats (95% overall detection rate). FCTI values, variability, and trends were in good agreement with available reference figures; intervals related to P and T waves were, respectively, underestimated and overestimated with respect to those estimated on averaged signals or obtained by other research groups. Errors were reduced and individual trends could be drawn. Conclusions. ICA permitted the reconstruction of reliable time course of fetal cardiac signals and the beat-to-beat calculation of time intervals, and normality ranges, with smaller errors with respect to previous studies. The retrieval of fetal traces with clear morphology and the longitudinal character of the study allowed estimating individual trends and beat-tobeat characterization, impossible with cross-sectional studies on averaged beats.

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confidence: 99%

Beat-to-beat estimate of fetal cardiac time intervals using magnetocardiography: longitudinal charts of normality ranges and individual trends

Comani

Liberati

Mantini

et al. 2005

Acta Obstet Gynecol Scand

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“…FMCG has been recognized as an alternative to fetal ECG, in particular during the second half of gestation 3,6 . Indeed, the coincidence of fMCG and fetal ECG obtained with scalp electrodes has been demonstrated in recent studies 28,29 …”

Section: Discussionmentioning

confidence: 96%

“…3,6 Indeed, the coincidence of fMCG and fetal ECG obtained with scalp electrodes has been demonstrated in recent studies. 28,29 In the presented cases, it was possible, by means of FastICA, to attain fetal cardiac signals with an excellent SNR and clearly defined P-QRS-T waves throughout the entire recordings. These conditions allowed the morphological classification of extrasystoles at a single beat level; subsequent evaluation on averaged beats confirmed the correct arrhythmia characterization.…”

Section: Analysis Of Heart Rate Variability (Hrv)mentioning

confidence: 90%

Characterization of Fetal Arrhythmias by Means of Fetal Magnetocardiography in Three Cases of Difficult Ultrasonographic Imaging

Comani

Liberati

Mantini

et al. 2004

Pacing Clinical Electrophis

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Characterization of ultrasound detected fetal arrhythmias is generally performed by means of M-mode and pulsed Doppler echocardiography (fECHO), sonographic techniques that allow only indirect and approximate reconstruction of the true electrophysiological events that occur in the fetal heart. Several studies demonstrated the ability of fetal magnetocardiography (fMCG) to identify fetal arrhythmias. We report on three women, studied after the 32nd gestational week, who were referred for fMCG because of unsatisfying fetal cardiac visualization with fECHO due to maternal obesity, fetus in constant dorsal position hiding the fetal heart, intrauterine growth retardation, and oligohydramnios. Minor pericardial effusion was present in the third patient and digoxin therapy was given. FMCG were recorded with a 77-channel MCG system working in a shielded room. Independent Component Analysis (FastICA algorithm) was used to reconstruct fetal signals. The good quality of the retrieved fetal signals allowed real-time detection of arrhythmias and their classification as supraventricular extrasystoles (SVE), with/without aberrant ventricular conduction and/or atrioventricular block. The time course of the fetal cardiac rhythm was reconstructed for the entire recording duration; hence, fetal heart rate variability could be studied in time and frequency. Since isolated extrasystoles may progress to more hazardous supraventricular tachycardias, the noninvasive antenatal characterization of, even transient, fetal arrhythmias and their monitoring during pregnancy can be of great clinical impact.

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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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The Coincidence of Fetal Magnetocardiography and Direct Electrocardiography in a Case of Fetal Atrial Flutter due to Intracardiac Tumor

Cited by 15 publications

References 16 publications

Beat-to-beat estimate of fetal cardiac time intervals using magnetocardiography: longitudinal charts of normality ranges and individual trends

Beat-to-beat estimate of fetal cardiac time intervals using magnetocardiography: longitudinal charts of normality ranges and individual trends

Characterization of Fetal Arrhythmias by Means of Fetal Magnetocardiography in Three Cases of Difficult Ultrasonographic Imaging

Simultaneous monitoring of separate fetal magnetocardiographic signals in twin pregnancy

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