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Magnetocardiographic Pacemapping for Nonfluoroscopic Localization of Intracardiac Electrophysiology Catheters
Author(s) -
FENICI RICCARDO,
PESOLA KATJA,
KORHONEN PETRI,
MÄKIJÄRVI MARKKU,
NEN JUKKA,
TOIVONEN LAURIE,
FENICI PETER,
KATILA TOIVO
Publication year - 1998
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1998.tb01207.x
Subject(s) - medicine , magnetocardiography , ventricle , nuclear medicine , reproducibility , nuclear magnetic resonance , torso , beat (acoustics) , biplane , biomedical engineering , cardiology , physics , anatomy , acoustics , engineering , aerospace engineering , statistics , mathematics
The purpose of the study was to validate, in patients, the accuracy of magnetocardiography (MCG) for three‐dimensional localization of an amagnetic catheter (AC) for multiple monophasic action potential (MAP) with a spatial resolution of 4 mm2. The AC was inserted in five patients after routine electrophysiological study. Four MAPs were simultaneously recorded to monitor the stability of endocardial contact of the AC during the MCG localization. MAP signals were band‐pass filtered DC‐500 Hz and digitized at 2 KHz. The position of the AC was also imaged by biplane fluoroscopy (XR), along with lead markers. MCG studies were performed with a multichannel SQUID system in the Helsinki BioMag shielded room. Current dipoles (5mm; 10mA), activated at the tip of the AC, were localized using the equivalent current dipole (ECD) model in patient‐specific boundary element torso. The accuracy of the MCG localizations was evaluated by: (1) anatomic location of ECD in the MRI, (2) mismatch with XR. The AC was correctly localized in the right ventricle of all patients using MRI. The mean three‐dimensional mismatch between XR and MCG localizations was 6 ± 2 mm (beat‐to‐beat analysis). The coefficient of variation of three‐dimensional localization of the AC was 1.37% and the coefficient of reproducibility was 2.6 mm. In patients, in the absence of arrhythmias, average local variation coefficients of right ventricular MAP duration at 50% and 90% ofrepolarization, were 7.4% and 3.1%, respectively. This study demonstrates that with adequate signal‐to‐noise ratio, MCG three‐dimensional localizations are accurate and reproducible enough to provide nonfluoroscopy dependant multimodal imaging for high resolution endocardial mapping of monophasic action potentials.