title: Pulsed-wave tissue Doppler echocardiography for the analysis of fetal cardiac arrhythmias.
abstract: OBJECTIVE
  Rhythm analysis of the fetal heart is hampered by the inability to routinely obtain electrocardiographic recordings of the fetus. Doppler studies of fetal cardiac tissue movements, assessing cardiac movements both qualitatively and quantitatively, have recently been described. We used a conventional high-resolution ultrasound system to obtain rhythm data from pulsed-wave tissue Doppler signals of the fetal heart in normal cardiac rhythm and in a variety of fetal cardiac arrhythmias.
  
  
  METHODS
  Fifty-five fetuses with normal (sinus) rhythm, 45 fetuses with rhythm disturbances and two neonates (one with arrhythmia and one with normal sinus rhythm) were studied. Using a conventional high-resolution ultrasound system equipped for fetal studies, but without specific tissue Doppler hardware or software, we performed pulsed-wave tissue Doppler echocardiography (PW-TDE) of atrioventricular valve ring excursions to study the atrial and ventricular mechanical actions. In the neonates, electrocardiograms were also recorded.
  
  
  RESULTS
  PW-TDE in normal fetuses shows a typical pattern of tissue motion parallel to the long axis of the heart and in the opposite direction to the blood flow, both in systole and diastole. This pattern is easily obtained from the tricuspid valve annulus in normal sinus rhythm and shows characteristic changes in various fetal arrhythmias.
  
  
  CONCLUSIONS
  PW-TDE of atrioventricular valve annulus movement patterns may prove to be a valuable additional tool for assessing fetal cardiac arrhythmias.
authors.affiliation: Department of Obstetrics and Gynecology, Bern University Hospital, Bern, Switzerland; Medical Faculty, Heinrich Heine University, Düsseldorf, Germany. tutschek@uni-duesseldorf.de
authors.forename: B
authors.initials: B
authors.lastname: Tutschek
authors.forename: K G
authors.initials: KG
authors.lastname: Schmidt
mesh_terms: D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging / Q000196:embryology / Q000503:physiopathology*; D001783:Blood Flow Velocity; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal