Key result
T-wave alternans was significantly higher in pregnant women with arrhythmic fetuses compared to those with normal-rhythm fetuses (median 28 vs 12 μV).
Why the study?
In pregnancy, maternal cardiovascular disease increases the fetus's risk of inherited cardiac genetic disorders, motivating evaluation of electrocardiographic alternans as a noninvasive marker of cardiac electrical instability.
Does electrocardiographic alternans differ between pregnant women with normal-rhythm fetuses and those with arrhythmic fetuses?
Observational (n=23)
Does electrocardiographic alternans differ between pregnant women with normal-rhythm fetuses and those with arrhythmic fetuses?
Higher T-wave alternans in pregnant women may reflect a more unstable maternal cardiac electrical condition associated with fetal arrhythmias.
Answers are grounded in this paper and cite their sources.
Maternal TWA elevation may reflect electrical instability linked to fetal arrhythmias; hypothesis-generating and needs prospective validation before any clinical use.
In pregnancy, if the woman has a cardiovascular disease, her fetus has an increased risk of inherited cardiac genetic disorders. Aim of this study was to evaluate electrocardiographic alternans (ECGA, <tex>μ V)</tex> of 23 pregnant women, comparing 12 mothers of fetuses with normal rhythm (Mum_NRF) and 11 mothers of arrhythmic fetuses (Mum_ArrF). ECGA is a noninvasive cardiac electrical risk marker able to reveal heart electrical instability. ECGA manifests in the ECG as P-wave alternans (PWA), QRS alternans (QRSA) and/or T-wave alternans (TWA). Analysis was performed by the enhanced adaptive matched filter method. ECGA distributions were expressed as: median (interquartile range). Comparisons were performed by the Wilcoxon rank-sum test. Although showing similar heart rate (Mum_NRF: 85 (19) bpm; Mum_ArrF: 90 (13) bpm), ECGA was higher in Mum_ArrF population than Mum_NRF one (PWA: 9 (7) <tex>μ V\ vs. 14 (14) μ V;</tex> QRSA: 9 (10) <tex>μ V\ vs</tex> . 17 (16) <tex>μ V,</tex> TWA: 12 (14) <tex>μ Vvs. 28(17) μ V)</tex>, but only TWA distributions were statistically different. Moreover, TWA was higher than in a female healthy population (on average <tex>18μ V)</tex>in 70% of Mum_ArrF, vs. 33% of Mum_NRF. Thus, higher TWA in our Mum_ArrF seems to reflect a more unstable heart electrical condition of arrhythmic fetuses' mothers than normal-rhythm fetuses' mothers.
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Marcantoni et al. (2021) conducted an observational in Pregnancy (n=23). Fetal arrhythmia vs. Normal fetal rhythm was evaluated on T-wave alternans (TWA). T-wave alternans was significantly higher in pregnant women with arrhythmic fetuses compared to those with normal-rhythm fetuses (median 28 vs 12 μV).
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