ArticleJournal of electrocardiology
The natural history of fetal long QT syndrome.
Article in Journal of electrocardiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 28 citations in OpenAlex.
- Low Baseline Fetal Heart Rate Leads to Diagnosis of Long QT Syndrome Type 1.JACC. Case reports · 2024Article
- Independent component analysis algorithms for non-invasive fetal electrocardiography.PloS one · 2023Article
- A Bio-Social Model during the First 1000 Days Optimizes Healthcare for Children with Developmental Disabilities.Biomedicines · 2022Review
- Presentation and genetic confirmation of long QT syndrome in the fetus.HeartRhythm case reports · 2022Article
- Maternal mosaicism in long QT syndrome due to a pathogenic variant inHeartRhythm case reports · 2021Article
- Fetal diagnosis of KCNQ1-variant long QT syndrome using fetal echocardiography and magnetocardiography.Pacing and clinical electrophysiology : PACE · 2020Article
- Noninvasive Fetal Electrocardiography in the Diagnosis of Long QT Syndrome: A Case Series.Fetal diagnosis and therapy · 2020Article
- Magnetocardiography on an isolated animal heart with a room-temperature optically pumped magnetometer.Scientific reports · 2018Article
- A Potential Diagnostic Approach for Foetal Long-QT Syndrome, Developed and Validated in Children.Pediatric cardiology · 2018Article
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
Abstract
introductionFetal magnetocardiography (fMCG), the magnetic analog of ECG, has provided invaluable insight into the mechanisms of fetal arrhythmias. In the past 15years, we have evaluated over 300 fetuses with arrhythmia by fMCG. We review the unique characteristics and natural history of the long QT syndrome (LQTS) rhythms.
methodsWe reviewed the fMCGs of subjects referred with suspected LQTS based on either a positive family history or echo diagnosis of the LQTS rhythms (sinus bradycardia, ventricular tachycardia, or 2:1 AV conduction) to the Biomagnetism laboratory in the Department of Medical Physics, UW-Madison. We recorded fMCGs using a 37-channel (Magnes, 4D Neuroimaging, Inc., San Diego, CA) superconducting quantum interference device (SQUID) biomagnetometer, housed in a magnetically-shielded room for 1200-6000s. Signal processing was used to remove maternal interference. Cardiac intervals (R-R, p, QRS, QT) were measured and compared to published normals. We correlated fetal heart rate (FHR) patterns and effects of fetal movement on FHR and rhythm using actocardiography.
resultsThirty-nine fetuses were studied at a mean of 28 (19-38) weeks of gestation. All had structurally normal hearts. One was on amiodarone for suspected supraventricular tachycardia and hydrops. Five had serial fMCGs. Isolated sinus bradycardia with a QTc >490ms was found in 35: 33 had a KCNQ1 mutation There was one false positive and one false negative LQTS diagnosis. Four fetuses had torsades de pointes (TdP) and 3 had periods of 2:1 conduction and either KCNH2 or SCN5A mutations. TdP was rarely initiated with a preceding long-short pattern and did not degenerate into ventricular fibrillation. One fetus with TdP died in utero, 2 with fetal TdP had postnatal cardiac arrest.
conclusionFetal LQTS is diagnosed by an fMCG QTc >490ms with an 89% sensitivity and specificity. TdP are seen with uncharacterized, KCNH2 or SCN5A R1623q mutations. Fetal TdP occurs when QTc ≥620ms. Identifying fetal LQTS and defining its rhythms by fMCG risk stratifies postnatal management.
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