Progress in Biomagnetic Imaging of Heart Arrhythmias

Moshage, Werner; Achenbach, Stephan; Weikl, A; Göhl, K.; Abraham-Fuchs, K.; Schneider, Siegfried; Bachmann, K.

doi:10.1007/978-3-642-76099-0_1

Cited by 23 publications

(9 citation statements)

References 7 publications

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“…The development of an amagnetic, MR-compatible pacing catheter permitted the exact verification of the localization accuracy of the combined method of multichannel magnetocardiography and MR imaging. Our investigations of paced and spontaneous arrhythmias could demonstrate that multichannel magnetocardiography constitutes a method that permits the non-invasive localization of arrhythmogenic tissues in the heart with an error of less than 10 mm [16][17].…”

Section: Discussionmentioning

confidence: 98%

Clinical magnetocardiography: Experience with a biomagnetic multichannel system

et al. 1991

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The magnetic fields caused by the human heart's electrical activity were coherently recorded with a biomagnetic multichannel system (KRENIKON) during 1 to 10 minutes in 49 patients. 31 to 37 magnetic channels were recorded simultaneously with the ECG and respiration. Comparison of a magnetic index and the Sokolow-Lyon index to echocardiographic findings in the quantification of left ventricular hypertrophy demonstrated the superiority of the magnetocardiogram (MCG) as compared to the ECG. The magnetocardiographic investigation of patients with WPW-Syndrome, ventricular extrasystoles, ventricular tachycardia, and paced ventricular beats demonstrated that multichannel magnetocardiography permits the non-invasive three dimensional localization of arrhythmogenic tissue with high spatial accuracy.

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Section: Discussionmentioning

confidence: 98%

Clinical magnetocardiography: Experience with a biomagnetic multichannel system

et al. 1991

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“…This could suggest that the MCG method, although impressively accurate in some instances, cannot yet assure the ideal spatial resolution absolutely necessary for catheter ablation procedures [Oeff, unpublished data, Weissmuller et al, this issue]. On the other hand MCG 3D localization of an artificial dipole pacing the human heart has been found to be much more accurate both in our study [17] and in a recent one [28]. This suggests that the MCG method is intrinsically accurate and that the reported localization uncertainties could be at least in part linked to the use of inappropriate validation criteria.…”

Section: C G Mapping During Cardiac Catheterizationmentioning

confidence: 37%

“…The MCG reliability for localization of intracardiac sources, in fact has been confirmed also by other authors, working with shielding and modern multichannel instrumentations both on patients with WPW Syndrome and with ventricular arrhythmias [27,28]. However when invasive catheter mapping has been used as goldstandard for validation, the reported range of localization uncertainty is somehow counterdicting.…”

Section: C G Mapping During Cardiac Catheterizationmentioning

confidence: 53%

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Clinical magnetocardiography

1991

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Since the introduction, in 1982, of a Biomagnetic facility in the clinical environment, efforts were concentrated to investigate whether magnetocardiography could really provide new information of potential diagnostic use, even avoiding electromagnetic shielding to facilitate simultaneous biomagnetic and conventional cardiac investigations, including cardiac catheterization for invasive electrophysiological procedures. More than 350 patients have been magnetically investigated using a single-channel second-order gradiometer. Results of 281 MCG studies, whose data have been extensively analyzed with updated software programs, are reported. Magnetocardiographic (MCG) mapping during endocardial pacing was performed to quantify the accuracy of MCG localization of intracardiac dipolar sources. MCG classification of ventricular preexcitation has been attempted in 70 patients with overt preexcitation. MCG localization of the ventricular preexcited area was accurate and reproducible, provided that during mapping a sufficient degree of ventricular preexcitation was present. MCG mapping during orthodromic A-V re-entry tachycardia has been also employed to attempt the localization of retrograde atrial preexcitation as well as the site of origin of atrial and ventricular tachyarrhythmias. For validation, the results of catheter and epicardial mappings have been used. Other applications of clinical magnetocardiography are under evaluation. The use of the Relative smoothness index needs, in our opinion, a larger experience to define its reliability as a predictor of risk for sudden death. MCG follow-up study of patients with transplanted hearts seems to be a promising application, for early detection of acute graft rejection reaction. Our reported case strongly supports this potentiality. Present work is also addressed to develop an integrated system allowing easy MCG mapping during cardiac catheterization, as a new method to guide diagnostic and therapeutic procedures as close as possible to the arrhythmogenic substrate.

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“…However the accuracy of biomagnetic source localization is surely higher, as it has been demonstrated by the tank measurements [19] and recently confirmed by similar measurements carried out with a multichannel instrumentation [22]. Even better results could be expected when an inhomogeneous volume conductor model of the torso, having individually-tailored geometry, will be used for the inverse solution [Van Oosterom 1991, this issue].…”

Section: Discussionmentioning

confidence: 78%

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

Fenici

Melillo

1991

Int J Cardiac Imag

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A multipurpose catheter, specially designed to be biomagnetically localizable and the method for magnetocardiographic (MCG) guided intracardiac electrophysiological recordings, endomyocardial biopsy and ablation of cardiac arrhythmias are described. The catheter features two non-polarizable non-ferrous magnetic electrodes, arranged in such a way that, connected to an external current generator, an electromagnetic field of dipolar configuration can be generated in the heart. The connection is done with twisted pairs of non-ferrous magnetic conductors, to avoid the occurrence of spurious magnetic fields along the catheter during current injection to the electrodes. With this assembly the tip of the catheter can be localized (and driven close to an arrhythmogenic area) by MCG mapping. The same electrodes are feasible for monophasic action potential (MAP) recordings. One or more lumen allow fluid infusion, blood sampling, pressure measurements and introduction of steerable wires, pacing or ablation electrodes, bioptic devices, or optic fibers. On the basis of preoperative MCG three-dimensional localization of the arrhythmogenic substrate, the biomagnetically localizable catheter is driven, under fluoroscopic control, as close as possible to the suspected arrhythmogenic zone. MCG mapping is then performed under pacing, with adjustments of the catheter's tip, until the electrically induced magnetic field and catheter's localization parameters fit those generated by the spontaneous arrhythmia. MAP is recorded. The catheter position is accepted for ablation when electrophysiological abnormalities are identified in the MCG localized area.

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Progress in Biomagnetic Imaging of Heart Arrhythmias

Cited by 23 publications

References 7 publications

Clinical magnetocardiography: Experience with a biomagnetic multichannel system

Clinical magnetocardiography: Experience with a biomagnetic multichannel system

Clinical magnetocardiography

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

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