SPEAKERS ABSTRACTS The application of super slow review of ultrasound clips to a diagnosis of fetal tachyarrhythmia Name and surname: Jun Yoshimatsu Institution: National Cerebral and Cardiovascular Center Email: yoshimatsu.jun.hp@ncvc.go.jp Objective Fetal arrhythmias occur in 1–2% of all pregnant cases. Premature atrial contraction (PAC), premature ventricular contraction (PVC) which are clinically benign are relatively common and do not require therapy. In contrast supraventricular tachycardias (SVTs), atrial flutter (AFL), ventricular tachycardia which are life-threatening are relatively rare but require treatment. These tachyarrhythmias easily complicate fetal congestive heart failure which can be followed by a fetal death. Thus, prenatal treatment for SVT and AFL is warranted to convert to sinus rhythm. Recently our group demonstrated that protocol-defined transplacental treatment for fetal SVT and AFL was effective and tolerable in 90% of cases. In order to choose the appropriate medication for fetal tachyarrhythmia the accurate diagnosis is important. Because fetal electrocardiography is still not available fetal echocardiography is commonly used for the diagnosis of fetal arrhythmia. The M-mode and Doppler echocardiography may achieve prenatal identification of arrhythmic types. The easier method helps more accurate and precise diagnosis of it. Recent advances of ultrasound examination technology allows a high spatial resolution and high temporal resolution at the same time. The image editing of video clips of four chamber view, which is the most easier image plane, is applicable for the diagnosis of fetal arrhythmias. We conducted the research to innovate the useful video clip editing method including a super slow motion for the precise diagnosis of fetal arrhythmias. Method From our fetal echocardiography database, 55 fetal echocardiography video clips (35 AFL, 20 SVT) were reviewed. Four chamber view clips of each case were selected. Every clips were edited into 10% speed. One examiner inserted the clip maker at the timing of atrial contraction and ventricular contraction. The intervals between ventricular contraction and atrial contraction were measured. Also the number of times of contraction of atrium and ventricle and their relations were recorded. Results Every contractions of each portion (atrium and ventricle) could be detected easily with edited video clips. The differentiation between AFL and SVT could be done completely by counting the number of contractions of atrium and ventricle. Also the V-A intervals and the A-V intervals could be measured in one hundredth seconds. In all cases, the diagnosis is compatible with that had made postnatally. Conclusion The first step of this study was depended on the examiner’s naked eyes helped by editing application. The accuracy of each steps of this study were satisfactory. This is the preliminary step to conduct the deep learning of Artificial Intelligence (AI). The most important point of using AI is setting up what to teach and how to teach. Our study showed the possibility of the application of AI to make a diagnosis of fetal tachyarrhythmia.

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世界围产医学大会

演讲者摘要 超慢速检查超声片段在胎儿快速性心律失常诊断中的应用 姓名：Jun Yoshimatsu 机构：国家脑和心血管中心 电子邮件：yoshimatsu.jun.hp@ncvc.go.jp 目的 胎儿心律失常发生在 1–占所有怀孕病例的 2%。临床良性的房性早搏 (PAC)、室性早搏 (PVC) 相对常见，不需要治疗。相比之下，危及生命的室上性心动过速 (SVT)、房扑 (AFL)、室性心动过速相对罕见但需要治疗。这些快速心律失常很容易使胎儿充血性心力衰竭复杂化，随后可能导致胎儿死亡。因此，有必要对 SVT 和 AFL 进行产前治疗以转变为窦性心律。最近，我们的小组证明，方案定义的经胎盘治疗胎儿 SVT 和 AFL 在 90% 的病例中是有效且可耐受的。为了为胎儿快速性心律失常选择合适的药物，准确的诊断很重要。由于胎儿心电图仍不可用，胎儿超声心动图常用于诊断胎儿心律失常。M型和多普勒超声心动图可以实现心律失常类型的产前识别。更简单的方法有助于更准确和精确的诊断。超声检查技术的最新进展允许同时具有高空间分辨率和高时间分辨率。四腔视图视频剪辑的图像编辑是最容易的图像平面，适用于胎儿心律失常的诊断。我们进行了研究以创新有用的视频剪辑编辑方法，包括用于精确诊断胎儿心律失常的超慢动作。方法 从我们的胎儿超声心动图数据库中，回顾了 55 个胎儿超声心动图视频剪辑（35 个 AFL，20 个 SVT）。每个案例的四个房间视图剪辑被选中。每个剪辑都被编辑成 10% 的速度。一名检查者在心房收缩和心室收缩的时间插入夹子制作器。测量心室收缩和心房收缩之间的间隔。还记录了心房和心室的收缩次数及其关系。结果 每个部分（心房和心室）的每一次收缩都可以通过编辑过的视频剪辑轻松检测到。AFL 和 SVT 之间的区别完全可以通过计算心房和心室收缩的次数来完成。VA 间隔和 AV 间隔也可以在百分之一秒内测量。在所有情况下，诊断都与出生后所做的诊断一致。结论 本研究的第一步是通过编辑应用程序帮助检查者的肉眼。这项研究的每个步骤的准确性都令人满意。这是进行人工智能（AI）深度学习的初步步骤。使用人工智能最重要的一点是设置教什么以及如何教。我们的研究显示了应用人工智能诊断胎儿快速性心律失常的可能性。VA 间隔和 AV 间隔也可以在百分之一秒内测量。在所有情况下，诊断都与出生后所做的诊断一致。结论 本研究的第一步是通过编辑应用程序帮助检查者的肉眼。这项研究的每个步骤的准确性都令人满意。这是进行人工智能（AI）深度学习的初步步骤。使用人工智能最重要的一点是设置教什么以及如何教。我们的研究显示了应用人工智能诊断胎儿快速性心律失常的可能性。VA 间隔和 AV 间隔也可以在百分之一秒内测量。在所有情况下，诊断都与出生后所做的诊断一致。结论 本研究的第一步是通过编辑应用程序帮助检查者的肉眼。这项研究的每个步骤的准确性都令人满意。这是进行人工智能（AI）深度学习的初步步骤。使用人工智能最重要的一点是设置教什么以及如何教。我们的研究显示了应用人工智能诊断胎儿快速性心律失常的可能性。这项研究的每个步骤的准确性都令人满意。这是进行人工智能（AI）深度学习的初步步骤。使用人工智能最重要的一点是设置教什么以及如何教。我们的研究显示了应用人工智能诊断胎儿快速性心律失常的可能性。这项研究的每个步骤的准确性都令人满意。这是进行人工智能（AI）深度学习的初步步骤。使用人工智能最重要的一点是设置教什么以及如何教。我们的研究显示了应用人工智能诊断胎儿快速性心律失常的可能性。