Development of a Beat to Beat Fetal Electrocardiogram

逐搏胎儿心电图的开发

• 批准号: 10115774
• 负责人: Anita Krishnan
• 金额: $ 22.31万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-01 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10115774
• 关键词: Affect; Age; Algorithms; Arrhythmia; Cardiac; Cardiology; Cardiotocography; Cessation of life; Child; Clinic; Clinical; Clinical Research; Data; Data Set; Detection; Development; Devices; Diagnosis; Diagnostic; Diagnostic tests; Disease; Echocardiography; Electrocardiogram; Emotional; Engineering; Ensure; Environment; Fetal Death; Fetal Heart; Fetal Monitoring; Fetus; Funding; Future; Gestational Age; Goals; Gold; Heart Rate; Infant; International; Intervention; Lead; Life; Long QT Syndrome; Magnetic Resonance Imaging; Maternal-fetal medicine; Measurement; Measures; Medical center; Methodology; Modification; Monitor; Operative Surgical Procedures; Outcome; Parents; Patients; Pediatric Hospitals; Performance; Pharmaceutical Preparations; Physics; Play; Positioning Attribute; Pregnancy; Process; Reader; Reproducibility; Resolution; Role; Savings; Second Pregnancy Trimester; Signal Transduction; Site-Directed Mutagenesis; Specialist; Survival Rate; System; Techniques; Testing; Third Pregnancy Trimester; Time; Toxicity Tests; Ultrasonography; United States; United States National Institutes of Health; Universities; Visualization; Washington; Woman; Work; cost; design; experience; fetal; heart rhythm; high risk; improved; infant death; neonatal death; novel; portability; postnatal; prototype; signal processing; stillbirth; time interval; tool; voltage

Project Summary There are 24,000 stillbirths per year in the United States, and 2.6 million stillbirths per year worldwide, with no significant decrease in the last decade. Abnormal fetal heart rhythms, such as long QT syndrome, are thought to play an important role in these deaths, and may cause 3-10% of unexplained stillbirths. This is in addition to known fetal arrhythmias, which affect 1-3% of pregnancies per year. A magnetocardiogram is the gold standard to detect these disorders, but is not portable or practical for widespread use. Other available tools such as ultrasound and cardiotocography cannot measure the intervals needed to diagnose and guide management of life threatening arrhythmias. The ideal tool for diagnosing and guiding therapy for arrhythmias is an electrocardiogram (ECG). Unfortunately, clinicians do not widely use the existing fetal electrocardiogram (fECG) devices for a variety of reasons: they do not work throughout all of gestation, can miss brief arrhythmias, have a delay between the actual rhythm and displayed rhythm, do not work in multiple gestations, and lack resolution of important intervals. Our team is developing a methodology to detect a continuous, time-resolved fECG using a novel implementation of adaptive interference cancellation (AIC). This proposal will build on our preliminary work to create a fECG clinical prototype and evaluate its performance in maternal patients at our pediatric hospital. This device is designed to generate an fECG regardless of gestational age, position, or pregnancies involving multiple fetuses. In this proposal, we aim to: 1. Transition an engineering prototype fECG to a clinical prototype by modifying the signal processing algorithm and user interface using existing datasets. 2. Measure cardiac time intervals in 16-40 week gestation fetuses and assess the reproducibility of these measurements between two readers. If successful, fetal cardiologists could use this tool to diagnose and treat known and latent fetal arrhythmias with existing anti-arrhythmic therapies. Globally, it could serve as a low cost tool to screen for arrhythmias that lead to stillbirth and to monitor fetuses for compromise during surgery, maternal medication use, and fetal interventions. Clinically implementing this critical diagnostic tool will be a landmark in the field of fetal cardiology.

项目摘要 美国每年有24,000人死亡，全球每年有260万个死产，没有 在过去的十年中大幅下降。认为异常的胎儿心律（例如长QT综合征）被认为 在这些死亡中发挥重要作用，并可能导致3-10％的无法解释的死产。这是补充 已知的胎儿心律不齐，每年影响1-3％的怀孕。心电图是黄金 可以检测这些疾病的标准，但对于广泛使用而不是便携式或实用性。其他可用工具 例如超声和心脏图无法测量诊断和指导所需的间隔 管理威胁性心律失常的管理。心律不齐的诊断和指导疗法的理想工具 是心电图（ECG）。不幸的是，临床医生不会广泛使用现有的胎儿心电图 （FECG）设备出于多种原因：它们在妊娠中不工作，可能会错过简短的 心律不齐，在实际节奏和显示节奏之间有延迟，在多个妊娠中不起作用， 并且缺乏重要间隔的分辨率。 我们的团队正在开发一种方法，以使用小说来检测连续的，时间分辨的FECG 自适应干扰取消（AIC）的实施。这项建议将以我们的初步工作为基础 创建FECG临床原型，并在我们的小儿医院评估其在母亲患者中的表现。 该设备旨在生成FECG，而不管涉及的胎龄，位置或怀孕如何 多个胎儿。在此提案中，我们的目标是： 1。通过修改信号处理，过渡工程原型FECG到临床原型 使用现有数据集的算法和用户界面。 2。测量16-40周妊娠胎儿的心脏时间间​​隔，并评估这些的可重复性 两个读者之间的测量。 如果成功，胎儿心脏病专家可以使用此工具来诊断和治疗已知和潜在的胎儿心律不齐 现有的抗心律失常疗法。在全球范围内，它可以用作筛选心律不齐的低成本工具 导致死产并监测手术期间胎儿的折衷方案，孕产妇使用和胎儿 干预措施。临床实施此关键诊断工具将是胎儿领域的地标 心脏病学。

项目成果

Frequency-Based Maternal Electrocardiogram Attenuation for Fetal Electrocardiogram Analysis.

• DOI: 10.1007/s10439-022-02959-4
• 发表时间: 2022-07
• 期刊: ANNALS OF BIOMEDICAL ENGINEERING
• 影响因子: 3.8
• 作者: Roshanitabrizi, Pooneh;Krishnan, Anita;Ingbar, Catherine;Salvador, Tyler;Zhang, Anqing;Donofrio, Mary T.;Govindan, Rathinaswamy
• 通讯作者: Govindan, Rathinaswamy