{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:23:51Z","timestamp":1780374231621,"version":"3.54.1"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,8,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Ebstein's anomaly and tricuspid valve dysplasia are associated with perinatal mortality approaching 50% and are among the most difficult fetal conditions to manage. Prediction of perinatal mortality is difficult and remains an active area of research. The usefulness of electrophysiologic indicators has not been investigated.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">Eighteen fetuses with a diagnosis of Ebstein's anomaly and tricuspid valve dysplasia were referred for fetal magnetocardiography evaluation. We assessed fetal rhythm, waveform intervals, and heart rate variability and reactivity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Two subjects were lost to follow\u2010up and 1 remains in utero. Of the other 15, 6 (40%) did not survive: 5 died within the first month of life, and 1 died at 4\u2009months following surgery. Compared with normal fetuses, the Ebstein's anomaly and tricuspid valve dysplasia group exhibited significantly prolonged P\u2010wave duration (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.01), PR interval (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.03), and QRS duration (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.01), along with an increased P\/QRS amplitude ratio (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.01). The most prominent fetal magnetocardiography abnormalities included tall, broad P\u2010waves suggestive of atrial enlargement and markedly prolonged QRS complexes consistent with bundle branch block. Of the 6 nonsurvivors, 4 had QRS durations \u226590\u2009milliseconds (Z &gt;4), and 4 demonstrated impaired atrioventricular conduction, including PR prolongation and second\u2010degree atrioventricular block. Additionally, 4 showed absent heart rate variability and minimal reactivity. Abnormal findings were more prevalent in the third trimester than earlier in gestation.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Ebstein's anomaly and tricuspid valve dysplasia manifests distinct conduction and rhythm abnormalities detectable by fetal magnetocardiography but not by echocardiography. These electrophysiologic markers were associated with perinatal mortality and may serve as useful prognostic indicators.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03047161.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.125.043614","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T11:48:39Z","timestamp":1753789719000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Fetal Conduction Disease and Arrhythmia in Ebstein's Anomaly and Tricuspid Valve Dysplasia Assessed by Fetal Magnetocardiography"],"prefix":"10.1161","volume":"14","author":[{"given":"Annette","family":"Wacker\u2010Gussmann","sequence":"first","affiliation":[{"name":"TUM University Hospital, School of Medicine & Health, Technical University of Munich","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6418-5193","authenticated-orcid":false,"given":"Gabriela","family":"Tardelli","sequence":"additional","affiliation":[{"name":"University of Wisconsin\u2010Madison","place":["Madison"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9085-0882","authenticated-orcid":false,"given":"Bettina F.","family":"Cuneo","sequence":"additional","affiliation":[{"name":"University of Arizona College of Medicine","place":["Tucson"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6986-2544","authenticated-orcid":false,"given":"Janette F.","family":"Strasburger","sequence":"additional","affiliation":[{"name":"Children\u2019s Wisconsin and Herma Heart Institute","place":["Milwaukee"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9894-0484","authenticated-orcid":false,"given":"Ronald T.","family":"Wakai","sequence":"additional","affiliation":[{"name":"University of Wisconsin\u2010Madison","place":["Madison"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.619338"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2023-322420"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-022-02908-x"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.04.024"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2007.11.049"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-012-0355-z"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-013-0680-x"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.015839"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.016684"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2016.03.008"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.037127"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90291-t"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.06.005"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437597.44550.5d"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2004.04.019"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.06.060"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.119.008082"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.004840"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.025224"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.09.022"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2006.872822"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6579\/ab0a2c"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000144302.30928.AA"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2022.04.012"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.eurheartj.a014868"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.2174\/1573403X16999201231203854"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2011.2131141"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.003673"},{"key":"e_1_3_1_30_2","first-page":"163","article-title":"Ebstein's anomaly: the clinical features and natural history of Ebstein's anomaly of the tricuspid valve","volume":"54","author":"Giuliani ER","year":"1979","unstructured":"Giuliani ER, Fuster V, Brandenburg RO, Mair DD. Ebstein's anomaly: the clinical features and natural history of Ebstein's anomaly of the tricuspid valve. Mayo Clin Proc. 1979;54:163\u2013173.","journal-title":"Mayo Clin Proc"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2000-6897"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-024-01744-8"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/joa.13179"},{"key":"e_1_3_1_34_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezaf119"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001211"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.3233\/NPM-230040"},{"key":"e_1_3_1_37_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20169"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.043614","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T12:13:36Z","timestamp":1756296816000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.043614"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,5]]},"references-count":36,"journal-issue":{"issue":"15","published-print":{"date-parts":[[2025,8,5]]}},"alternative-id":["10.1161\/JAHA.125.043614"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.043614","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,5]]},"assertion":[{"value":"2025-05-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e043614"}}