Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-24T13:15:20.305Z Has data issue: false hasContentIssue false
  • English
  • Français

Electrocardiographic intervals in foetuses with CHD

Published online by Cambridge University Press:  20 January 2015

Betul Yilmaz ,
Hari K. Narayan ,
Abigail Wilpers ,
Christina Wiess ,
William P. Fifer  and
Ismée A. Williams
Betul Yilmaz
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Morgan Stanley Children’s Hospital, Columbia University Medical Center, New York, United States of America
Hari K. Narayan
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Morgan Stanley Children’s Hospital, Columbia University Medical Center, New York, United States of America
Abigail Wilpers
Affiliation:
Department of Psychiatry, Columbia University, New York, United States of America
Christina Wiess
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Morgan Stanley Children’s Hospital, Columbia University Medical Center, New York, United States of America
William P. Fifer
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Morgan Stanley Children’s Hospital, Columbia University Medical Center, New York, United States of America Department of Psychiatry, Columbia University, New York, United States of America
Ismée A. Williams*
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Morgan Stanley Children’s Hospital, Columbia University Medical Center, New York, United States of America
*
Correspondence to: Dr I. A. Williams, MD, MS, Department of Pediatrics, Division of Pediatric Cardiology, Morgan Stanley Children’s Hospital of New York-Presbyterian, 3959 Broadway, MS-CHONY 2 North, New York, NY 10032, United States of America. Tel: 212-342-1560; Fax: 212-342-1563; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

To assess foetal electrocardiographic intervals across gestational age among foetuses with and without congenital heart disease, and to investigate differences between groups.

Design

A prospective observational cohort study.

Setting

Center for Prenatal Pediatrics, Morgan Stanley Children’s Hospital of NewYork-Presbyterian.

Population or sample

A total of 92 participants with singleton pregnancies, 41 with normal anatomy and 51 with congenital heart disease were included in this study.

Methods

Using a maternal abdominal monitor, foetal electrocardiogram was obtained serially from foetuses with and without congenital heart disease at 20–24 weeks (F1), 28–32 weeks (F2), and 34–38 weeks (F3) of gestation. A signal-averaged waveform was calculated, and PR, QRS, and QT intervals were measured. Intervals from controls were compared with gestational age norms. Using Pearson’s correlation coefficient, we analysed the relationship between gestational age and foetal electrocardiographic intervals. Intervals from control and congenital heart disease foetuses were compared by Student’s t-test.

Results

PR (r=0.333, p=0.02) and QRS (r=0.248, p=0.05) intervals correlated with gestational age only among controls. QRS intervals in foetuses with congenital heart disease were significantly longer than controls at F1 (63±6 versus 52±5 ms, p<0.001), F2 (61±8 versus 56±7 ms, p=0.02), and F3 (64±10 versus 56±9 ms, p=0.007).

Conclusions

PR and QRS intervals lengthen across gestational age among foetuses with normal cardiac anatomy but not in foetuses with congenital heart diseases. As early as 20 weeks of gestation, differences between foetuses with and without congenital heart disease are discernible, with congenital heart disease foetuses demonstrating longer QRS intervals compared with controls.

Keywords

Foetal electrocardiographycongenital heart diseaseelectrocardiographic intervals
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 1 , January 2016 , pp. 84 - 89
Check for updates
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Taylor, MJ, Smith, MJ, Thomas, M, et al. Non-invasive fetal electrocardiography in singleton and multiple pregnancies. BJOG 2003; 110: 668–678.Google Scholar
2. Brambati, B, Pardi, G. The intraventricular conduction time of fetal heart in uncomplicated pregnancies. Br J Obstet Gynaecol 1980; 87: 941–948.Google Scholar
3. Chia, EL, Ho, TF, Rauff, M, Yic, WC. Cardiac time intervals of normal fetuses using noninvasive fetal electrocardiography. Prenat Diagn 2005; 25: 546–552.CrossRefGoogle ScholarPubMed
4. Pardi, G, Marconi, AM, Ferrazzi, E. The intraventricular conduction time of fetal heart in pregnancies with suspected fetal growth retardation. Br J Obstet Gynaecol 1986; 93: 250–254.Google Scholar
5. Pardi, G, Ferrazzi, E, Cetin, I, et al. The clinical relevance of the abdominal fetal electrocardiogram. J Perinat Med 1986; 14: 371–377.Google Scholar
6. Graatsma, EM, Jacod, BC, van Egmond, LA, Mulder, EJ, Visser, GH. Fetal electrocardiography: feasibility of long-term fetal heart rate recordings. BJOG 2009; 116: 334–337; discussion 337–338.Google Scholar
7. Graatsma, EM, Miller, J, Mulder, EJ, Harman, C, Baschat, AA, Visser, GH. Maternal body mass index does not affect performance of fetal electrocardiography. Am J Perinatol 2010; 27: 573–577.Google Scholar
8. Reinhard, J, Hayes-Gill, B, Yi, Q, Hatzmann, H, Schiermeier, S. Comparison of non-invasive fetal electrocardiogram to Doppler cardiotocogram during the 1st stage of labor. J Perinat Med 2010; 38: 179–185.Google Scholar
9. Reinhard, J, Hayes-Gill, BR, Schiermeier, S, et al. Intrapartum signal quality with external fetal heart rate monitoring: a two way trial of external Doppler CTG ultrasound and the abdominal fetal electrocardiogram. Arch Gynecol Obstet 2012; 286: 1103–1107.Google Scholar
10. Reinhard, J, Hayes-Gill, BR, Schiermeier, S, Hatzmann, H, Heinrich, TM, Louwen, F. Intrapartum fetal and maternal heart rate ambiguity – a comparison of Doppler ultrasound CTG and the abdominal fetal electrocardiogram with maternal electrocardiogram. Gynecol Obstet Invest 2013; 75: 101–108.Google Scholar
11. Mehta, C, Dhillon, R. Understanding paediatric ECGs. Curr Paediatr 2004; 14: 229–236.Google Scholar
12. Lev, M, Killian, ST. Hypoplasia of the aorta without transposition with electrocardiographic and histopathologic studies of the conduction system. Am Heart J 1942; 24: 794–806.Google Scholar
13. Siddiqui, S, Wilpers, A, Weiss, C, et al. Autonomic regulation in fetuses with congenital heart disease. Congenit Heart Dis 2013; 8: 457 (abstract).Google Scholar