A Recent Article Of Interest

(The following is an abstract of an article "Transoceanic Biotelemetry of the Fetal Electrocardiogram via Relay Satellite" by Saul D. Larks, Ph.D., of Marquette University, Milwaukee, Wisconsin, which appeared in the report of the National Electronics Conference, 1964.)

The electronic instruments required for the direct transmission of primary biological data over long distances have been in existence for some time, and international telemetry of bio-medical data has been under consideration in many quarters. The transmission of such information by satellite involves technical problems which offer a challenge to the skill of engineers and bio-engineers.

Aspects of the recent thalidomide disaster in West Germany have served to bring into focus the possibilities of the uses of international biotelemetry for earlier recognition of similar problems that may arise in the future. There was a considerable delay in the international dissemination of the information after the recognition of the teratogenic effects of thalidomide. This delay might have been avoided if a system had been in existence to transmit primary biological data to research centers by international telemetry.

In addition to the well-known limb malformation (phocomelia) caused by thalidomide, it also caused a variety of other defects, including congenital cardiac malformations capable of being detected by electrocardiogram at an early stage of gestation. Thus, a significant rise in the number of abnormal fetal electrocardiograms in a given area (or research center) would alert medical and health authorities to the possibility of a teratogenic agent at work five or six months earlier than would otherwise be possible.

If this primary data were received throughout a network of research centers by means of international telemetry, the causative agent could be identified more quickly and warnings disseminated simultaneously throughout the world. The damage could be held to an absolute minimum by this means.

The possibility of a new outbreak such as the thalidomide disaster is very real. Since it has happened once in an advanced country, we can presume that it will happen again.

BIOTELEMETRY EXPERIMENTS

To explore the possibilities and study the technical problems involved in the transmission of primary biological data, a series of experiments has been conducted. These experiments involve the cooperation of the obstetric staff of Mount Sinai Hospital in Milwaukee, the staff of Parkview Hospital in Fort Wayne, Dr. Antoine Remond and his laboratory staff in Paris, Dr. Claude Sureau of the University of Paris, Dr. Charles Ray of the Mayo Clinic, the National Aeronautics and Space Administration, and Mr. William K. Hagan, Medical Electronics section chief of the Magnavox Company.

The tests made were:

(1) National telemetry via standard telephone lines - After preliminary local tests, a fetal electrocardiogram was sent directly from a mother at Parkview Hospital in Fort Wayne, Indiana, to the Fetal Heart Station at Marquette University in Milwaukee, Wisconsin.

(2) International telemetry via cable - On May 7, 1963, a fetal electrocardiogram was sent on-line from a mother at Mount Sinai Hospital in Milwaukee to Dr. Remond's laboratory in Paris, where Dr. Ray, receiving solely on an aural basis, was able to distinguish both maternal and fetal signals and to estimate the two rates with good accuracy.

(3) International telemetry via Relay I satellite -- By May 28, 1963, the Remond laboratory had been provided with the necessary data receiver for AM-FM conversion, and multichannel recording equipment. At 2:15 P.M. local time, a fetal electrocardiogram was transmitted from Milwaukee to Paris via orbit number 1291 of Relay I satellite. The fetal electrocardiogram was successfully received and recorded.

RESULTS

These tests show that it is perfectly possible to pick up or acquire microvolt signals (such as the fetal electrocardiograms) , appropriately amplify and condition such signals, and convert from AM to FM for telephone transmission via cable or satellite Relay. Cable link can be used where channels are available. However, a much broader capability exists via satellite communication which theoretically could reach any corner of the earth, including areas where no lines or cables exist.

SUGGESTED APPLICATION

A network of 12 data acquisition station points might be set up in major population centers around the world. Fetal electrocardiograms would be transmitted to the Fetal Heart Station on a random basis on scheduled days, or sampled at random. Normal values and ranges for each population would be established. A sudden significant increase in abnormal electrocardiograms would be a sufficient basis for an alert.

International biotelemetry of the fetal electrocardiogram via satellite would seem to be a vital and practical step in the interest of the people's health.