Noninvasive Classification of Ventricular Preexcitation with Unshielded Magnetocardiography and Transesophageal Atrial Pacing and Follow‐Up

Abstract

MCG was more accurate than ECG for the classification of VPx and provided additional information in the non-invasive EP assessment of patients with WPW syndrome.

Magnetocardiographic electroanatomical imaging for pre-interventional evaluation of arrhythmogenic substrates

“…Some results have been reported in recent papers [8][9][10]. MCG 3D-EAI was successful in patients with WPW syndrome, atrial flutter and ventricular arrhythmias.…”

“…MCG can monitor and map quickly transient arrhythmic events whenever needed, even in emergency, without any discomfort and with very short data acquisition time. Multimodal integration of MCG with 3D rendering of the patient's heart from CT or MR images is useful to characterize several kinds of arrhythmogenic mechanisms, such as accessory pathways, atrial or ventricular ectopic foci [8][9][10], different types of reentry in patients with atrial flutter or fibrillation [13][14][15][16]. MCG is useful to define the stability of the arrhythmogenic substrate and to plan the most appropriate interventional approach.…”

From 3D to 4D imaging: is that useful for interventional cardiac electrophysiology?

“…We have previously evaluated the accuracy of MCG localization of cardiac sources experimentally [10], [11] and in clinical studies [14], [15], using simple models such as ECD and EMD. However, in the physiological reality, multiple current sources are simultaneously activated during almost all the cardiac cycle.…”

“…Our most recent results with MCG-based 3D electroanatomical imaging have been described elsewhere [14], [15]. However an example of pre-ablation imaging of a right-sided Kent-type accessory pathway in a patients with the Wolff-Parkinson-White syndrome is given in Fig.…”

“…MCG has the advantage to be contactless, with fixed sensors position and less sensitive to the contribution of tissue conductivity thus faster and theoretically more reliable for non-invasive localization and 3D imaging of cardiac sources [12], [13]. At the moment both invasive and non-invasive 3D-EAI is achieved by multimodal integration of electrophysiological information into static 3D cardiac models and CT or MR images [14]. However this can induce inaccuracy of noninvasive source localization as well as inappropriate realtime imaging of catheters, because of cardiac movements, due to contractile activity and to respiration, in respect of surface or external sensors [15].…”