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European Heart Journal 1993 14(2):168-174;
Copyright © 1993 by the European Society of Cardiology.
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© 1993 The European Society of Cardiology

Non-invasive magnetocardiographic localization of ventricular pre-excitation in the Wolff-Parkinson-White syndrome using a realistic torso model

J. NENONEN, M. MÄKIJÄRVI*, L. TOIVONEN*, K. FORSMAN, M. LEINIÖ, J. MONTONEN, A. JÄRVINEN{dagger}, P. KETO{ddagger}, P. HEKALI{ddagger}, T. KATILA and P. SILTANEN*

Helsinki University of Technology, Department of Technical Physics, Laboratory of Biomedical Engineering 02150 Espoo, Finland
*Helsinki University Central Hospital, First Department of Medicine, Cardiovascular Laboratory 00290 Helsinki, Finland
{dagger}Helsinki University Central Hospital, Department of Thoracic and Cardiovascular Surgery 00290 Helsinki, Finland
{ddagger}Helsinki University Central Hospital, Departmeni of Radiology 00290 Helsinki, Finland

Received 5 November 1991; revised 7 May 1992; .

Correspondence Jukka Nenonen, Dr Techn. Helsinki University of Technology. Department of Technical Physics, Laboratory of Biomedical Engineering. 02150 Espoo, Finland

Abstract

This study was performed to evaluate the accuracy of magnetocardiography in non-invasive localization of the ventricular pre-excitation site in patients suffering from the Wolff-Parkinson-White (WPW) syndrome. Twelve WPW patients were studied, in whom the pre-excitation caused serious supraventricular arrhythmias refractory to drug therapy. Magnetocardiographic measurements were performed in a magnetically shielded room, and non-invasive localization was computed from preprocessed magnetic signals using a current dipole source in a realistically shaped digital torso. All patients underwent intra-operative multicatheter mapping and subsequent dissection of the accessory atrioventricular connection. The intra-operative localization results were marked on magnetic resonance images of the heart, where magnetocardiographic results were also superimposed to allow comparison. The average of the three-dimensional differences between the magnetocardiographic and the invasive results was 2.1 ± 0.9 cm. In all cases, the computed localization result was in the same or adjacent anatomical region as the intra-operative result. The present results show that the magnetocardiographic method using a realistic torso model is capable of localizing pre-excitation sites with sufficient accuracy to provide extra information so that non-pharmacological therapeutic interventions can be applied.

Key Words: Magnetocardiography • Wolff-Parkinson-White syndrome • non-invasive localization • cardiac modelling


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