Unshielded magnetocardiography: Repeatability and reproducibility of automatically estimated ventricular repolarization parameters in 204 healthy subjects

Sorbo, Anna Rita; Lombardi, Gianmarco; Brocca, Lara La; Guida, Gianluigi; Fenici, Riccardo; Brisinda, Donatella

doi:10.1111/anec.12526

Cited by 10 publications

(7 citation statements)

References 51 publications

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“…The usefulness of MCG for a better understanding of the arrhythmogenic mechanisms underlying the high-risk J syndromes ( 225 , 327 – 336 ); the identification of atrial arrhythmogenic vulnerability ( 248 ), of left atrial dysfunction ( 330 ), and of the atrial propagation pathways ( 228 ); and the dominant frequencies ( 181 , 183 , 189 , 232 ) in patients with atrial fibrillation, as well as providing accurate pre-interventional 3D localization of arrhythmogenic substrates ( 128 , 193 , 247 , 249 , 331 ), has been widely reported. However, the lack of a clinical breakthrough at scale is evident.…”

Section: Discussionmentioning

confidence: 99%

Clinical magnetocardiography: the unshielded bet—past, present, and future

Brisinda,

Fenici,

Fenici

2023

Front. Cardiovasc. Med.

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Magnetocardiography (MCG), which is nowadays 60 years old, has not yet been fully accepted as a clinical tool. Nevertheless, a large body of research and several clinical trials have demonstrated its reliability in providing additional diagnostic electrophysiological information if compared with conventional non-invasive electrocardiographic methods. Since the beginning, one major objective difficulty has been the need to clean the weak cardiac magnetic signals from the much higher environmental noise, especially that of urban and hospital environments. The obvious solution to record the magnetocardiogram in highly performant magnetically shielded rooms has provided the ideal setup for decades of research demonstrating the diagnostic potential of this technology. However, only a few clinical institutions have had the resources to install and run routinely such highly expensive and technically demanding systems. Therefore, increasing attempts have been made to develop cheaper alternatives to improve the magnetic signal-to-noise ratio allowing MCG in unshielded hospital environments. In this article, the most relevant milestones in the MCG's journey are reviewed, addressing the possible reasons beyond the currently long-lasting difficulty to reach a clinical breakthrough and leveraging the authors’ personal experience since the early 1980s attempting to finally bring MCG to the patient's bedside for many years thus far. Their nearly four decades of foundational experimental and clinical research between shielded and unshielded solutions are summarized and referenced, following the original vision that MCG had to be intended as an unrivaled method for contactless assessment of the cardiac electrophysiology and as an advanced method for non-invasive electroanatomical imaging, through multimodal integration with other non-fluoroscopic imaging techniques. Whereas all the above accounts for the past, with the available innovative sensors and more affordable active shielding technologies, the present demonstrates that several novel systems have been developed and tested in multicenter clinical trials adopting both shielded and unshielded MCG built-in hospital environments. The future of MCG will mostly be dependent on the results from the ongoing progress in novel sensor technology, which is relatively soon foreseen to provide multiple alternatives for the construction of more compact, affordable, portable, and even wearable devices for unshielded MCG inside hospital environments and perhaps also for ambulatory patients.

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Section: Discussionmentioning

confidence: 99%

Clinical magnetocardiography: the unshielded bet—past, present, and future

Brisinda,

Fenici,

Fenici

2023

Front. Cardiovasc. Med.

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“…Magnetocardiography enables the measurement of electrical vectors in the heart in 3D, and with recent advances in clinical measurements of atrial and ventricular activation and repolarization without geomagnetic field shielding, it has become significantly more accessible [ 140 , 141 ]. However, (i) it requires additional imaging to project electrical source information to the underlying cardiac structure, (ii) it cannot be used to measure transmembrane voltages, and (iii) it works best in combination with ECG due to different sensitivities to in-plane versus out-of-plane wave propagation [ 142 , 143 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiac Conduction Velocity, Remodeling and Arrhythmogenesis

Han

Trew

Zgierski-Johnston

2021

Cells

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Cardiac electrophysiological disorders, in particular arrhythmias, are a key cause of morbidity and mortality throughout the world. There are two basic requirements for arrhythmogenesis: an underlying substrate and a trigger. Altered conduction velocity (CV) provides a key substrate for arrhythmogenesis, with slowed CV increasing the probability of re-entrant arrhythmias by reducing the length scale over which re-entry can occur. In this review, we examine methods to measure cardiac CV in vivo and ex vivo, discuss underlying determinants of CV, and address how pathological variations alter CV, potentially increasing arrhythmogenic risk. Finally, we will highlight future directions both for methodologies to measure CV and for possible treatments to restore normal CV.

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“…Magnetocardiography (MCG) has been proposed a non-invasive, radiation-free and quick-testing technique to record cardiac magnetic field with high reproducibility (1,2). Magnetic measurements are non-invasive and noncontact, meaning that the magnetic signals detected by MCG are less influenced by body tissues, compared to electric currents detected by electrocardiography (ECG).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of magnetocardiography to identify patients in need of coronary artery revascularization: a cross-sectional study

Huang¹,

Hua²,

Tang³

et al. 2020

Cardiovasc Diagn Ther

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Background: Patients with angina-like symptoms need invasive or non-invasive angiography to determine whether revascularization is necessary. For patients in need of revascularization, undergoing coronary computed tomography angiography (CCTA) may delay the treatment of revascularization and increase exposure to contrast agents and radiation. The aim of this cross-sectional study was to accessed the effectiveness of magnetocardiography (MCG) to identify patients who should undergo coronary revascularization. Methods: A total of 203 patients who were suffering from angina-like symptoms and underwent percutaneous coronary angiography (PCA) between July 27, 2015 and April 10, 2017 at the 8th Medical Center of Chinese PLA General Hospital, were enrolled in this cross-sectional study. In all patients, 12lead electrocardiography (ECG) and MCG test were performed before PCA. For each subject. The value at every single sampling point was extracted from T wave of each MCG channel in time sequence. Pearson's correlation coefficients were calculated for each two T-waves. A binary logistic regression diagnosis model of these coefficients was established to identify patients in need of revascularization.Results: Ten pairings of coefficients were entered into diagnostic regression model as covariates. The area under the receiver operating characteristic (ROC) curve (AUC) was 0.747 (95% CI: 0.680-0.815), and the asymptotic P value was less than 0.001. At the cut-off value of 0.55, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 72.9%, 65.9%, 74.8%, 63.6% and 69.9%, and the positive and negative post-test probabilities were 65.9% and 25.7%. The accuracy, sensitivity, specificity, PPV and NPV for 12-lead ECG were 67.0%, 62.7%, 63.5%, 70.5% and 55.1%, respectively. However, when those acute myocardial infarction (AMI) patients were ruled out from both

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Unshielded magnetocardiography: Repeatability and reproducibility of automatically estimated ventricular repolarization parameters in 204 healthy subjects

Abstract: Reliable MCG can be performed into an unshielded hospital ambulatory, with repeatability and reproducibility of quantitative assessment of VR adequate for clinical purposes. Wider clinical use is foreseen with the development of multichannel optical magnetometry.

Cited by 10 publications

References 51 publications

Clinical magnetocardiography: the unshielded bet—past, present, and future

Clinical magnetocardiography: the unshielded bet—past, present, and future

Cardiac Conduction Velocity, Remodeling and Arrhythmogenesis

Effectiveness of magnetocardiography to identify patients in need of coronary artery revascularization: a cross-sectional study

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