Localization of a ventricular tachycardia-focus with multichannel magnetocardiography and three-dimensional current density reconstruction.

The objective of this case report is to determine the accurate localization of a malignant ventricular tachycardia (VT) focus by combining multichannel magnetocardiographic (MCG) information with morphologic data. The localization was obtained by calculating the three-dimensional current density distribution (3D-CDD) on the left ventricular surface. To estimate the accuracy of this localization technique, examinations of a healthy volunteer were additionally performed. The MCG-signals were recorded in a magnetically shielded room by a 49-channel magnetogradiometer. The corresponding morphologic information was recorded by magnetic resonance tomography (MRT). The coordinate systems were matched with the help of markers. The 3D-CDD was calculated by the Philips CURRY software package. The origin of a malignant VT determined by X-ray images of the ablation catheter position during the electrophysiological examination (EPE), was used as the gold standard. This was then compared with the localization results obtained by the 3D-CDD. It was found that the localization coordinates showed a difference of less than 10 mm.

[1]  L Trahms,et al.  Magnetocardiographic analysis of the two-dimensional distribution of intra-QRS fractionated activation. , 1999, Physics in medicine and biology.

[2]  A modified linear estimation approach for solving biomagnetic inverse problems , 1996 .

[3]  R. Fenici,et al.  Magnetocardiographically-guided catheter ablation. , 1995, Journal of interventional cardiology.

[4]  D. Drung.  The PTB 83-SQUID system for biomagnetic applications in a clinic , 1995, IEEE Transactions on Applied Superconductivity.

[5]  J. Nenonen.  Solving the inverse problem in magnetocardiography , 1994, IEEE Engineering in Medicine and Biology Magazine.

[6]  M Burghoff,et al.  Magnetocardiographic Localization of the Origin of Ventricular Ectopic Beats , 1994, Pacing and clinical electrophysiology : PACE.

[7]  Olaf Dössel,et al.  Possibilities of Functional Brain Imaging Using a Combination of MEG and MRT , 1994 .

[8]  T. Katila,et al.  Magnetocardiography: supraventricular arrhythmias and preexcitation syndromes. , 1993, European heart journal.

[9]  R. Fenici,et al.  Magnetocardiography: ventricular arrhythmias. , 1993, European heart journal.

[10]  K. Abraham-Fuchs,et al.  Magnetocardiography: three-dimensional localization of the origin of ventricular late fields in the signal averaged magnetocardiogram in patients with ventricular late potentials. , 1993, European heart journal.

[11]  R. Ilmoniemi,et al.  Magnetoencephalography-theory, instrumentation, and applications to noninvasive studies of the working human brain , 1993 .

[12]  P. Savard,et al.  Pace Mapping Using Body Surface Potential Maps to Guide Catheter Ablation of Accessory Pathways in Patients With Wolff‐Parkinson‐White Syndrome , 1993, Circulation.

[13]  K. Kuck,et al.  Single-catheter approach to radiofrequency current ablation of left-sided accessory pathways in patients with Wolff-Parkinson-White syndrome. , 1991, Circulation.

[14]  T. Katila,et al.  Magnetocardiographic functional localization using current multipole models , 1991, IEEE Transactions on Biomedical Engineering.

[15]  R. Lazzara,et al.  Catheter ablation of accessory atrioventricular pathways (Wolff-Parkinson-White syndrome) by radiofrequency current. , 1991, The New England journal of medicine.

[16]  Y. Nakaya,et al.  [Magnetocardiographic localization of an accessory pathway in patients with WPW syndrome]. , 1990, Journal of cardiology.

[17]  R. Maniewski,et al.  On the accuracy of source localisation in cardiac measurements. , 1987, Physics in medicine and biology.

[18]  M. Agnello,et al.  Inverse problem solution in cardiomagnetism using a current multipole expansion of the primary sources. , 1987, Physics in medicine and biology.

[19]  A. C. Bruno,et al.  Magnetic localisation of a current dipole implanted in dogs. , 1987, Physics in medicine and biology.

[20]  J. Sarvas.  Basic mathematical and electromagnetic concepts of the biomagnetic inverse problem. , 1987, Physics in medicine and biology.

[21]  E. Prystowsky,et al.  Determination of the earliest site of ventricular activation in Wolff-Parkinson-White syndrome: application of digital continuous loop two-dimensional echocardiography. , 1986, Journal of the American College of Cardiology.

[22]  D. Geselowitz.  On the magnetic field generated outside an inhomogeneous volume conductor by internal current sources , 1970 .