PR interval: A comparison of electrical and mechanical methods in the fetus
| Autor: | Matthew J. Thomas, Myles J.O. Taylor, Cristian Belmar, Salome Oseku-Afful, Anna N. Seale, Lucia Pasquini, Michael Roughton, H. M. Gardiner |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
medicine.medical_specialty Cardiotocography Wilcoxon signed-rank test Heart block Electrocardiography Fetus Pregnancy Internal medicine Linear regression Heart rate medicine Humans PR interval Prospective cohort study medicine.diagnostic_test business.industry Obstetrics and Gynecology Heart Rate Fetal medicine.disease Pediatrics Perinatology and Child Health Cardiology Female business Fetal echocardiography |
| Zdroj: | Early Human Development. 83:231-237 |
| ISSN: | 0378-3782 |
| DOI: | 10.1016/j.earlhumdev.2006.05.020 |
| Popis: | Mechanical surrogates are used to assess fetal cardiac electrical activity.To compare electrical PR interval measured using non-invasive fetal electrocardiography (fECG) with mechanical atrioventricular (AV) interval using Doppler.Prospective study of 55 recordings made in 50 human fetuses. Those with structural heart defects, second degree or complete heart block were excluded.Mechanical AV interval was measured from the onset of mitral A wave to onset of aortic ejection. Electrical PR interval was measured from a coherent averaged signal obtained using non-invasive fECG recorded from the maternal abdomen. Wilcoxon signed rank test was used to compare both methods. Agreement between AV and PR intervals was assessed using linear regression and by Bland-Altman plots. Bland-Altman analysis assessed inter-observer and intra-observer variability.There was no significant difference in the heart rates of the 55 paired traces measured consecutively using both methods (p0.35). AV interval was longer than PR (median [range] 116 [96-169] vs. 102 [75-143] ms; p0.001), with mean difference -16.47 ms (95% Confidence Interval -43.43, 10.44), reflecting the increased proportion of the cardiac cycle measured. Using fECG, PR inter-observer and intra-observer mean differences were 0.4 ms (CI -7.29, 8.09) and 0.7 ms (CI -3.22, 4.62) respectively. R values for inter and intra-observer studies were 0.95 and 0.99 respectively. Using Doppler methods, AV inter-observer and intra-observer mean differences were -2.69 ms, (CI -15.33, 9.95) and 0.92 ms, (CI -9.41, 11.26) respectively. R values for AV measurements were 0.93 for inter-observer and 0.96 for intra-observer variation.Non-invasive fECG is a robust tool to measure the PR interval with narrow limits of agreement. |
| Databáze: | OpenAIRE |
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