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Nonfluoroscopic Localization of an Amagnetic Stimulation Catheter by Multichannel Magnetocardiography
Author(s) -
FENICI RICCARDO,
NEN JUKKA,
PESOLA KATJA,
KORHONEN PETRI,
LÖTJÖNEN JYRKI,
MÄKIJÄRVI MARKKU,
TOIVONEN LAURI,
POUTANEN VELIPEKKA,
KETO PEKKA,
KATILA TOIVO
Publication year - 1999
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.1540-8159.1999.tb00602.x
Subject(s) - medicine , catheter , fluoroscopy , magnetocardiography , torso , nuclear medicine , cardiology , radiology , anatomy
This study was performed to: (1) evaluate the accuracy of noninvasive magnetocardiographic (MCG) localization of an amagnetic stimulation catheter; (2) validate the feasibility of this multipurpose catheter; and (3) study the characteristics of cardiac evoked fields. A stimulation catheter specially designed to produce no magnetic disturbances was inserted into the heart of five patients after routine electrophysiological studies. The catheter position was documented on biplane cine x‐ray images. MCG signals were then recorded in a magnetically shielded room during cardiac pacing. Noninvasive localization of the catheter's tip and stimulated depolarization was computed from measured MCG data using a moving equivalent current‐dipole source in patient‐specific boundary element torso models. In all five patients, the MCG localizations were anatomically in good agreement with the catheter positions defined from the x‐ray images. The mean distance between the position of the tip of the catheter defined from x‐ray fluoroscopy and the MCG localization was 11 ± 4 mm. The mean three‐dimensional difference between the MCG localization at the peak stimulus and the MCG localization, during the ventricular evoked response about 3 ms later, was 4 ± 1 mm calculated from signal‐averaged data. The 95% confidence interval of beat‐to‐beat localization of the tip of the stimulation catheter from ten consecutive beats in the patients was 4 ± 2 mm. The propagation velocity of the equivalent current dipole between 5 and 10 ms after the peak stimulus was 0.9 ± 0.2 m/s. The results show that the use of the amagnetic catheter is technically feasible and reliable in clinical studies. The accurate three‐dimensional localization of this multipurpose catheter by multichannel MCG suggests that the method could be developed toward a useful clinical tool during electrophysiological studies.