Biomagnetically localizable multipurpose catheter and method for MCG guided intracardiac electrophysiology, biopsy and ablation of cardiac arrhythmias

Fenici, Riccardo; Melillo, G

doi:10.1007/bf01797753

Cited by 12 publications

(10 citation statements)

References 14 publications

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“…After the EPS, a catheter specially designed to produce no magnetic disturbances (Fenici et al 1996) was inserted in the heart. In all ten cases, the catheter was placed in the right ventricle.…”

Section: Measurement and Stimulation Protocolmentioning

confidence: 99%

Bioelectromagnetic localization of a pacing catheter in the heart

Pesola¹,

Nenonen

Fenici

et al. 1999

Phys. Med. Biol.

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The accuracy of localizing source currents within the human heart by non-invasive magneto- and electrocardiographic methods was investigated in 10 patients. A non-magnetic stimulation catheter inside the heart served as a reference current source. Biplane fluoroscopic imaging with lead ball markers was used to record the catheter position. Simultaneous multichannel magnetocardiographic (MCG) and body surface potential mapping (BSPM) recordings were performed during catheter pacing. Equivalent current dipole localizations were computed from MCG and BSPM data, employing standard and patient-specific boundary element torso models. Using individual models with the lungs included, the average MCG localization error was 7+/-3 mm, whereas the average BSPM localization error was 25+/-4 mm. In the simplified case of a single homogeneous standard torso model, an average error of 9+/-3 mm was obtained from MCG recordings. The MCG localization accuracies obtained in this study imply that the capability of multichannel MCG to locate dipolar sources is sufficient for clinical purposes, even without constructing individual torso models from x-ray or from magnetic resonance images.

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Section: Measurement and Stimulation Protocolmentioning

confidence: 99%

Bioelectromagnetic localization of a pacing catheter in the heart

Pesola¹,

Nenonen

Fenici

et al. 1999

Phys. Med. Biol.

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“…The amagnetic catheters, used as an artificial source, have been previously described in detail [16]. Briefly, it featured multiple electrodes for clinical recording of multiple monophasic action potentials, pacing, and, at the same time, generation of geometrically-known electromagnetic dipoles adequate for MCG source localization (length 6 mm, current 10 mA, duration 20 ms, and variable pulse rate, usually 3 Hz).…”

Section: Experimental Instrumentationmentioning

confidence: 99%

Phantom Assessment of Unshielded Magnetocardiography Repeatability, Precision and Accuracy in Electric Sources Localization

Lombardi¹,

Rita²,

Fenici³

et al. 2017

Ann Heart

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Background: Pre-interventional knowledge of arrhythmogenic substrate location may reduce interventional time and arrhythmias ablation risks. Magnetocardiographic Mapping (MCG) is a contactless method for noninvasive localization of intracardiac sources used for Three-Dimensional (3D) Electro-Anatomical Imaging (EAI) of arrhythmogenic substrates. The aim of this study was to assess the repeatability, precision, and accuracy of MCG in localizing dipolar sources in an unshielded environment. Methods: The phantom consisted of a rectangular plastic box filled with 0.9% NaCl saline solution. Multiple artificial current dipoles (6 mm length, 10 mA, 50 Hz) were induced with two a magnetic electro-catheters. The distance between two dipoles was constant. 30 seconds MCG recordings (bandwidth DC-200 Hz, 1 KHz sampling rate) were performed with 36 DC-SQUID sensors at distances between Sensors plane and Dipole Sources (SSD) decreasing from 18 to 9 cm. MCG localization was assessed by inverse solution based on the Equivalent Magnetic Dipole (EMD) model. Orthogonal fluoroscopic imaging, employing lead markers to correct for x-ray divergence effect, was used to define the 3D physical relative position of each dipole. MCG repeatability, precision and accuracy were evaluated. The correlation between precision, Goodness of Fit (GOF) of the EMD model and SSD was also analyzed. Results: Overall, optimal repeatability (Coefficient of Variation ± Standard Error of the Mean = 0.79 ± 0.43%, 3D absolute error = 0.26 ± 0.25 cm), average localization precision (1.13 ± 0.42 cm) and average accuracy (0.2 ± 0.13 cm) were found. Localization precision improved (0.87 ± 0.3 cm) with GOF of the model increasing above 73% and SSD lower than 14 cm. Conclusion: Contactless MCG provides optimal precision and accuracy in localizing dipolar sources, even when performed in an unshielded environment. By integrating source localization into cardiac 3D imaging by cardiac magnetic resonance, MCG is foreseen to provide both pre-interventional and intraoperative 3D-EAI of arrhythmogenic substrates.

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“…Both methods provide a unique link between noninvasive and invasive 3D electroanatomical imaging of electrophysiologic parameters. The amagnetic catheter can be guided at the site of onset of an arrhythmia, under 3D MCG imaging, and can be simultaneously used to validate the arrhythmogenic substrate by aimed multi-MAP recordings and pacing (FIGURE 10) [401][402][403][404][405][406].…”

Section: Cardiac Source Localization and Imaging Of Arrhythmogenic Mechmentioning

confidence: 99%

Clinical application of magnetocardiography

Fenici¹,

Brisinda²,

Meloni³

2005

Expert Review of Molecular Diagnostics

136

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Magnetocardiography is a noninvasive contactless method to measure the magnetic field generated by the same ionic currents that create the electrocardiogram. The time course of magnetocardiographic and electrocardiographic signals are similar. However, compared with surface potential recordings, multichannel magnetocardiographic mapping (MMCG) is a faster and contactless method for 3D imaging and localization of cardiac electrophysiologic phenomena with higher spatial and temporal resolution. For more than a decade, MMCG has been mostly confined to magnetically shielded rooms and considered to be at most an interesting matter for research activity. Nevertheless, an increasing number of papers have documented that magnetocardiography can also be useful to improve diagnostic accuracy. Most recently, the development of standardized instrumentations for unshielded MMCG, and its ease of use and reliability even in emergency rooms has triggered a new interest from clinicians for magnetocardiography, leading to several new installations of unshielded systems worldwide. In this review, clinical applications of magnetocardiography are summarized, focusing on major milestones, recent results of multicenter clinical trials and indicators of future developments.

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Biomagnetically localizable multipurpose catheter and method for MCG guided intracardiac electrophysiology, biopsy and ablation of cardiac arrhythmias

Cited by 12 publications

References 14 publications

Bioelectromagnetic localization of a pacing catheter in the heart

Bioelectromagnetic localization of a pacing catheter in the heart

Phantom Assessment of Unshielded Magnetocardiography Repeatability, Precision and Accuracy in Electric Sources Localization

Clinical application of magnetocardiography

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