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Repolarization predictors of fetal long QT syndrome
BACKGROUND: Diagnosis of fetal long QT syndrome (LQTS) using fetal magnetocardiography (fMCG) is straightforward in cases of overt QTc prolongation accompanied by LQTS rhythms; however, cases of isolated QTc prolongation can be challenging. OBJECTIVE: The purpose of this study was to characterize re...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7853638/ https://www.ncbi.nlm.nih.gov/pubmed/33543149 http://dx.doi.org/10.1016/j.hroo.2020.05.003 |
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author | Strand, Sarah Strasburger, Janette F. Lutter, William J. Wakai, Ronald T. |
author_facet | Strand, Sarah Strasburger, Janette F. Lutter, William J. Wakai, Ronald T. |
author_sort | Strand, Sarah |
collection | PubMed |
description | BACKGROUND: Diagnosis of fetal long QT syndrome (LQTS) using fetal magnetocardiography (fMCG) is straightforward in cases of overt QTc prolongation accompanied by LQTS rhythms; however, cases of isolated QTc prolongation can be challenging. OBJECTIVE: The purpose of this study was to characterize repolarization in normal and phenotype-positive LQTS fetuses with the goal of using additional parameters of repolarization to improve the accuracy of fMCG diagnosis of LQTS. METHODS: fMCG recordings were taken from 37 phenotype-positive fetuses with confirmed LQTS and 132 normal controls. The normal fetuses were grouped into those with T and U waves and those with only T waves. We compared the repolarization characteristics of normal fetuses with only T waves with those of LQTS fetuses. We also compared the repolarization characteristics of normal fetuses with T and U waves with those of LQTS fetuses with 2-component T waves. RESULTS: Late-peaking T waves were strongly associated with LQTS (35/37 [95%]). No normal fetuses showed both QTc prolongation (QTc >500 ms) and a late-peaking T wave. U waves were seen in 11 normal fetuses (8%) and resulted in waveforms that often mimicked those of the 19 LQTS fetuses with 2-component T waves. However, in normal fetuses the polarities of the T and U waves were the same, whereas in LQTS fetuses with 2-component T waves the polarities of the components usually were opposite. CONCLUSION: A late-peaking T wave in association with QTc prolongation is a distinctive, reliable indicator of fetal LQTS. U waves confound assessment of QTc; however, normal U waves usually can be distinguished from LQTS T waves based on polarity. |
format | Online Article Text |
id | pubmed-7853638 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-78536382021-06-09 Repolarization predictors of fetal long QT syndrome Strand, Sarah Strasburger, Janette F. Lutter, William J. Wakai, Ronald T. Heart Rhythm O2 Clinical BACKGROUND: Diagnosis of fetal long QT syndrome (LQTS) using fetal magnetocardiography (fMCG) is straightforward in cases of overt QTc prolongation accompanied by LQTS rhythms; however, cases of isolated QTc prolongation can be challenging. OBJECTIVE: The purpose of this study was to characterize repolarization in normal and phenotype-positive LQTS fetuses with the goal of using additional parameters of repolarization to improve the accuracy of fMCG diagnosis of LQTS. METHODS: fMCG recordings were taken from 37 phenotype-positive fetuses with confirmed LQTS and 132 normal controls. The normal fetuses were grouped into those with T and U waves and those with only T waves. We compared the repolarization characteristics of normal fetuses with only T waves with those of LQTS fetuses. We also compared the repolarization characteristics of normal fetuses with T and U waves with those of LQTS fetuses with 2-component T waves. RESULTS: Late-peaking T waves were strongly associated with LQTS (35/37 [95%]). No normal fetuses showed both QTc prolongation (QTc >500 ms) and a late-peaking T wave. U waves were seen in 11 normal fetuses (8%) and resulted in waveforms that often mimicked those of the 19 LQTS fetuses with 2-component T waves. However, in normal fetuses the polarities of the T and U waves were the same, whereas in LQTS fetuses with 2-component T waves the polarities of the components usually were opposite. CONCLUSION: A late-peaking T wave in association with QTc prolongation is a distinctive, reliable indicator of fetal LQTS. U waves confound assessment of QTc; however, normal U waves usually can be distinguished from LQTS T waves based on polarity. Elsevier 2020-05-21 /pmc/articles/PMC7853638/ /pubmed/33543149 http://dx.doi.org/10.1016/j.hroo.2020.05.003 Text en © 2020 Heart Rhythm Society. Published by Elsevier Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Clinical Strand, Sarah Strasburger, Janette F. Lutter, William J. Wakai, Ronald T. Repolarization predictors of fetal long QT syndrome |
title | Repolarization predictors of fetal long QT syndrome |
title_full | Repolarization predictors of fetal long QT syndrome |
title_fullStr | Repolarization predictors of fetal long QT syndrome |
title_full_unstemmed | Repolarization predictors of fetal long QT syndrome |
title_short | Repolarization predictors of fetal long QT syndrome |
title_sort | repolarization predictors of fetal long qt syndrome |
topic | Clinical |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7853638/ https://www.ncbi.nlm.nih.gov/pubmed/33543149 http://dx.doi.org/10.1016/j.hroo.2020.05.003 |
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