Prenatal diagnosis · 2019
Noninvasive fetal electrocardiography for the detection of fetal arrhythmias.
Клиническое исследованиеСтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Behar Joachim A, Bonnemains Laurent, Shulgin Vyacheslav, Oster Julien, Ostras Oleksii, Lakhno Igor
Аннотация
OBJECTIVE: To assess whether noninvasive fetal electrocardiography (NI-FECG) enables the diagnosis of fetal arrhythmias.
METHODS: A total of 500 echocardiography and NI-FECG recordings were collected from pregnant women during a routine medical visit in this multicenter study. All the cases with fetal arrhythmias (n = 12) and a matching number of control (n = 14) were used. Two perinatal cardiologists analyzed the extracted NI-FECG while blinded to the echocardiography. The NI-FECG-based diagnosis was compared with the reference fetal echocardiography diagnosis.
RESULTS: NI-FECG and fetal echocardiography agreed on all cases (Ac = 100%) on the presence of an arrhythmia or not. However, in one case, the type of arrhythmia identified by the NI-FECG was incorrect because of the low resolution of the extracted fetal P-wave, which prevented resolving the mechanism (2:1 atrioventricular conduction) of the atrial tachycardia.
CONCLUSION: It is possible to diagnose fetal arrhythmias using the NI-FECG technique. However, this study identifies that improvement in algorithms for reconstructing the P-wave is critical to systematically resolve the mechanisms underlying the arrhythmias. The elaboration of a NI-FECG Holter device will offer new opportunities for fetal diagnosis and remote monitoring of problematic pregnancies because of its low-cost, noninvasiveness, portability, and minimal setup requirements.
METHODS: A total of 500 echocardiography and NI-FECG recordings were collected from pregnant women during a routine medical visit in this multicenter study. All the cases with fetal arrhythmias (n = 12) and a matching number of control (n = 14) were used. Two perinatal cardiologists analyzed the extracted NI-FECG while blinded to the echocardiography. The NI-FECG-based diagnosis was compared with the reference fetal echocardiography diagnosis.
RESULTS: NI-FECG and fetal echocardiography agreed on all cases (Ac = 100%) on the presence of an arrhythmia or not. However, in one case, the type of arrhythmia identified by the NI-FECG was incorrect because of the low resolution of the extracted fetal P-wave, which prevented resolving the mechanism (2:1 atrioventricular conduction) of the atrial tachycardia.
CONCLUSION: It is possible to diagnose fetal arrhythmias using the NI-FECG technique. However, this study identifies that improvement in algorithms for reconstructing the P-wave is critical to systematically resolve the mechanisms underlying the arrhythmias. The elaboration of a NI-FECG Holter device will offer new opportunities for fetal diagnosis and remote monitoring of problematic pregnancies because of its low-cost, noninvasiveness, portability, and minimal setup requirements.