title: Magnetocardiography in the evaluation of fetuses at risk for sudden cardiac death before birth.
abstract: BACKGROUND
  We hypothesized that fetuses at risk for sudden death may have abnormal conduction or depolarization, ischemia, or abnormal heart rate variability (HRV) detectable by magnetocardiography.
  
  
  METHODS
  Using a 37-channel biomagnetometer, we evaluated 3 groups of fetuses at risk for sudden death: group 1, critical aortic stenosis (AS); group 2, arrhythmias; and group 3, heart failure and in utero demise. Five to 10 recordings of 10-minute duration were recorded, and signal was averaged to determine rhythm, conduction intervals, HRV, and T-wave morphology.
  
  
  RESULTS
  In group 1, 2 of 3 had atrial and ventricular strain patterns. In (n = 53) group 2, 15% had prolonged QTc and 17% had T-wave alternans (TWA). Of 23 group 2 fetuses with atrioventricular block, 74% had ventricular ectopy, 21% had junctional ectopic tachycardia, and 29% had ventricular tachycardia. Group 3 (n = 2) had abnormal HRV and TWA.
  
  
  CONCLUSIONS
  Repolarization abnormalities, unexpected arrhythmias, and abnormal HRV suggest an arrhythmogenic mechanism for "sudden cardiac death before birth."
authors.affiliation: The Heart Institute for Children, Hope Children's Hospital, Rush Medical College, Chicago, IL, USA. cuneo@thic.com
authors.forename: Bettina F
authors.initials: BF
authors.lastname: Cuneo
authors.forename: Janette F
authors.initials: JF
authors.lastname: Strasburger
authors.forename: Ronald T
authors.initials: RT
authors.lastname: Wakai
mesh_terms: D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D005313:Fetal Death / Q000175:diagnosis* / Q000453:epidemiology*; D005323:Fetal Monitoring / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D053798:Magnetocardiography / Q000706:statistics & numerical data*; D008297:Male; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate; D014481:United States / Q000453:epidemiology