Noninvasive Fetal Electrocardiography in the Diagnosis of Long QT Syndrome: A Case Series

Neeta Sethi, Kiyoe Funamoto, Catherine Ingbar, Paige Mass, Jeffrey Moak, Ronald Wakai, Janette Strasburger, Mary Donofrio, Ahsan Khandoker, Yoshitaka Kimura, Anita Krishnan

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Introduction: Early detection and monitoring for malignant arrhythmias is fundamental to prenatal care in long QT syndrome (LQTS). Recently, we studied the feasibility of isolating the fetal electrocardiogram (fECG) and measuring electrocardiographic intervals with a noninvasive fECG device using blind source separation with reference signal. Our aim was to evaluate the ability of fECG to diagnose LQTS. Case Presentations: We identified 3 cases of clinically suspected LQTS based on fetal echocardiogram (2 had sinus bradycardia, 1 had second-degree atrioventricular block with negative maternal anti-SSA/SSB antibody titers). With institutional review board approval, these patients were prospectively enrolled for fECG acquisition. Offline post-processing generated fECG waveforms and calculated QT intervals. Case 1 and 3 had a maternal history of LQTS. Two of the three fetuses with suspected LQTS had confirmed LQTS by postnatal ECG and genetic testing. FECG was able to identify a prolonged corrected QT interval in both cases. One of these also had fetal magnetocardiography (fMCG), which yielded similar findings to the fECG. The third fetus had a normal fECG; fMCG and postnatal ECG were also normal. Conclusions: In 3 cases, fECG findings corroborated the diagnosis of LQTS. Noninvasive fECG may offer a novel method for fECG that is portable and more clinically accessible.

Original languageBritish English
Pages (from-to)711-716
Number of pages6
JournalFetal Diagnosis and Therapy
Volume47
Issue number9
DOIs
StatePublished - 1 Sep 2020

Keywords

  • Arrhythmias
  • Congenital long QT syndrome
  • Noninvasive fetal electrocardiography
  • Prenatal diagnosis

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