Faculty Collaboration Database

Magnetocardiographic rhythm patterns at initiation and termination of fetal supraventricular tachycardia. Circulation 2003 Jan 21;107(2):307-12

Date

01/23/2003

Pubmed ID

12538433

DOI

10.1161/01.cir.0000043801.92580.79

Scopus ID

2-s2.0-0037458130 (requires institutional sign-in at Scopus site)   109 Citations

Abstract

BACKGROUND: Using fetal magnetocardiography (fMCG), we characterize for the first time the electrophysiological patterns of initiation and termination of reentrant fetal supraventricular tachycardia (SVT), the most common form of life-threatening fetal arrhythmia.

METHODS AND RESULTS: In contrast to the expectation that reentrant SVT is initiated by spontaneous premature atrial contractions (PACs) and is terminated by spontaneous block, 5 distinct patterns of initiation and 4 patterns of termination were documented, with the most common patterns of initiation involving reentrant PACs. Waveform morphology and timing, including QRS and ventriculoatrial interval, were assessed. This enabled detection of such phenomena as Wolff-Parkinson-White syndrome, QRS aberrancy, and multiple reentrant pathways that were crucial for defining the rhythm patterns. In addition, fMCG actocardiography revealed an unexpectedly strong association between fetal trunk movement and the initiation and termination of SVT, suggesting that autonomic influences play a key role.

CONCLUSIONS: This study demonstrates that the patterns of initiation and termination of fetal SVT are more diverse than is generally believed and that the most common patterns of initiation involve reentrant PACs. The ability to discern such patterns can help elucidate the underlying mechanisms and guide antiarrhythmic drug therapy. fMCG provides a noninvasive means of analyzing complex tachyarrhythmia in utero, with efficacy approaching that of postnatal electrocardiographic rhythm monitoring.

Author List

Wakai RT, Strasburger JF, Li Z, Deal BJ, Gotteiner NL

Author

Janette F. Strasburger MD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cardiac Pacing, Artificial
Cohort Studies
Electrocardiography
Electromagnetic Phenomena
Female
Fetal Diseases
Fetal Movement
Fetus
Gestational Age
Heart Rate, Fetal
Humans
Infant, Newborn
Pregnancy
Prenatal Diagnosis
Reproducibility of Results
Tachycardia, Supraventricular