Noninvasive assessment of fetal cardiac electrophysiology has not been routinely possible despite many decades of fetal ECG research. Recently, however, we and other groups have demonstrated the efficacy of fetal magnetocardiography (fMCG), the magnetic analog of fetal ECG, as an effective new method of assessing fetal heart rate, rhythm, and conduction. The long-term goal of this program is to develop fMCG as a new technology for fetal investigation and clinical application. If successful, this research can improve the diagnosis of life-threatening forms of fetal arrhythmia and shed light on causes of unexplained fetal death. It can also provide an effective means of monitoring the effects of fetal therapies and can aid in the evaluation of new therapies. The short-term objective of the research proposed here is to extend the functionality of fMCG by combining it with other techniques and to perform further patient studies to increase the base of scientific knowledge in the nascent field of fetal cardiac electrophysiology.
The specific aims are as follows: 1. Develop and apply detectors based on statistical estimation and detection theory to identify repolarization abnormalities, such as QTc prolongation and T-wave alternans. 2. Develop and apply methodology for analysis of simultaneous fMCG/echocardiography recordings in order to directly compare fetal electrical and mechanical rhythm and evaluate fetal electromechanical function. 3. Combine fetal actocardiography with ultrasound surveillance in order to improve the assessment of fetal well-being. 4. Continue our studies of normal pregnancies and pregnancies complicated by fetal arrhythmia and other high-risk conditions, incorporating techniques developed in the preceding aims.

Public Health Relevance

The long-term goal of this program is to develop fMCG as a new technology for fetal investigation and clinical application. If successful, this research can improve the diagnosis of life-threatening forms of fetal arrhythmia and shed light on causes of unexplained fetal death. It can also provide an effective means of monitoring the effects of fetal therapies and can aid in the evaluation of new therapies.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
2R01HL063174-15A1
Application #
8579499
Study Section
Special Emphasis Panel (ZRG1-SBIB-V (82))
Program Officer
Baldwin, Tim
Project Start
1999-07-01
Project End
2017-05-31
Budget Start
2013-08-09
Budget End
2014-05-31
Support Year
15
Fiscal Year
2013
Total Cost
$417,851
Indirect Cost
$135,178
Name
University of Wisconsin Madison
Department
Physics
Type
Schools of Medicine
DUNS #
161202122
City
Madison
State
WI
Country
United States
Zip Code
53715
Peters, Carli; Wacker-Gussmann, Annette; Strasburger, Janette F et al. (2015) Electrophysiologic features of fetal ventricular aneurysms and diverticula. Prenat Diagn 35:129-36
Wacker-Gussmann, Annette; Strasburger, Janette F; Cuneo, Bettina F et al. (2014) Diagnosis and treatment of fetal arrhythmia. Am J Perinatol 31:617-28
Wacker-Gussmann, Annette; Strasburger, Janette F; Cuneo, Bettin F et al. (2014) Fetal arrhythmias associated with cardiac rhabdomyomas. Heart Rhythm 11:677-83
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Cuneo, Bettina F; Strasburger, Janette F; Yu, Suhong et al. (2013) In utero diagnosis of long QT syndrome by magnetocardiography. Circulation 128:2183-91
Wiggins, Delonia L; Strasburger, Janette F; Gotteiner, Nina L et al. (2013) Magnetophysiologic and echocardiographic comparison of blocked atrial bigeminy and 2:1 atrioventricular block in the fetus. Heart Rhythm 10:1192-8
Yu, Suhong; Van Veen, Barry D; Wakai, Ronald T (2013) Detection of T-wave alternans in fetal magnetocardiography using the generalized likelihood ratio test. IEEE Trans Biomed Eng 60:2393-400
Murphy, Lisa L; Moon-Grady, Anita J; Cuneo, Bettina F et al. (2012) Developmentally regulated SCN5A splice variant potentiates dysfunction of a novel mutation associated with severe fetal arrhythmia. Heart Rhythm 9:590-7
Mensah-Brown, Nana Aba; Lutter, William J; Comani, Silvia et al. (2011) Independent component analysis of normal and abnormal rhythm in twin pregnancies. Physiol Meas 32:51-64
Lutter, William J; Wakai, Ronald T (2011) Indices and detectors for fetal MCG actography. IEEE Trans Biomed Eng 58:1874-80

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