Characterizing atomic magnetic gradiometers for fetal magnetocardiography.

Atomic magnetometers (AMs) offer many advantages over superconducting quantum interference devices due to, among other things, having comparable sensitivity while not requiring cryogenics. One of the major limitations of AMs is the challenge of configuring them as gradiometers. We report the development of a spin-exchange relaxation free vector atomic magnetic gradiometer with a sensitivity of 3 fT cm-1 Hz-1/2 and common mode rejection ratio >150 in the band from DC to 100 Hz. We introduce a background suppression figure of merit for characterizing the performance of gradiometers. It allows for optimally setting the measurement baseline and for quickly assessing the advantage, if any, of performing a measurement in a gradiometric mode. As an application, we consider the problem of fetal magnetocardiography (fMCG) detection in the presence of a large background maternal MCG signal.

Low-Cost Fetal Magnetocardiography: A Comparison of Superconducting Quantum Interference Device and Optically Pumped Magnetometers.

Background Fetal magnetocardiography (fMCG) is a highly effective technique for evaluation of fetuses with life-threatening arrhythmia, but its dissemination has been constrained by the high cost and complexity of Superconducting Quantum Interference Device (SQUID) instrumentation. Optically pumped magnetometers (OPMs) are a promising new technology that can replace SQUIDs for many applications. This study compares the performance of an fMCG system, utilizing OPMs operating in a person-sized magnetic shield, to that of a conventional fMCG system, utilizing SQUID magnetometers operating in a magnetically shielded room. Methods and Results fMCG recordings were made in 24 subjects using the SQUID system with the mother lying supine in a magnetically shielded room and the OPM system with the mother lying prone in a person-sized, cylindrical shield. Signal-to-noise ratios of the OPM and SQUID recordings were not statistically different and were adequate for diagnostic purposes with both technologies. Although the environmental noise was higher using the small open-ended shield, this was offset by the higher signal amplitude achieved with prone positioning, which reduced the distance between the fetus and sensors and improved patient comfort. In several subjects, fMCG provided a differential diagnosis that was more precise and/or definitive than was possible with echocardiography alone. Conclusions The OPM-based system was portable, improved patient comfort, and performed as well as the SQUID-based system at a small fraction of the cost. Electrophysiological assessment of fetal rhythm is now practical and will have a major impact on management of fetuses with long QT syndrome and other life-threatening arrhythmias.

Magnetocardiography Using a Magnetoresistive Sensor Array.

In previous magnetocardiography studies, magnetocardiograms (MCGs) have been obtained using superconducting quantum interference device (SQUID) systems. SQUID is the most sensitive instrument for measuring low-frequency magnetic fields, but it requires liquid helium for cooling, so operating costs are high. In contrast, magnetoresistive (MR) magnetometers function by detecting the change in resistance, caused by an external magnetic field, and have much lower costs. This study was aimed to evaluate feasibility of the MR sensor array for acquiring MCGs.We used an MR sensor array, which was developed for measuring magnetic fields in the picotesla range, with a reduced noise level (TDK Corporation, Tokyo, Japan). A 30-channel MR sensor array was placed in a magnetically shielded room, and the cardiac magnetic field over the anterior chest walls of five healthy subjects was recorded.For all five subjects, MCGs were successfully recorded using the MR sensor array. The cardiac magnetic field corresponding to P, QRS, and T waves on an electrocardiogram (ECG) was detectable by signals averaging 272 ± 27.5 beats.An MR sensor array can be used to measure cardiac magnetic fields. Our results will contribute to the development of low-cost devices for recording MCGs, which will help develop non-invasive diagnostics in cardiovascular medicine.

Signal Space Separation Method for a Biomagnetic Sensor Array Arranged on a Flat Plane for Magnetocardiographic Applications: A Computer Simulation Study.

Although the signal space separation (SSS) method can successfully suppress interference/artifacts overlapped onto magnetoencephalography (MEG) signals, the method is considered inapplicable to data from nonhelmet-type sensor arrays, such as the flat sensor arrays typically used in magnetocardiographic (MCG) applications. This paper shows that the SSS method is still effective for data measured from a (nonhelmet-type) array of sensors arranged on a flat plane. By using computer simulations, it is shown that the optimum location of the origin can be determined by assessing the dependence of signal and noise gains of the SSS extractor on the origin location. The optimum values of the parameters LC and LD , which, respectively, indicate the truncation values of the multipole-order ℓ of the internal and external subspaces, are also determined by evaluating dependences of the signal, noise, and interference gains (i.e., the shield factor) on these parameters. The shield factor exceeds 104 for interferences originating from fairly distant sources. However, the shield factor drops to approximately 100 when calibration errors of 0.1% exist and to 30 when calibration errors of 1% exist. The shielding capability can be significantly improved using vector sensors, which measure the x, y, and z components of the magnetic field. With 1% calibration errors, a vector sensor array still maintains a shield factor of approximately 500. It is found that the SSS application to data from flat sensor arrays causes a distortion in the signal magnetic field, but it is shown that the distortion can be corrected by using an SSS-modified sensor lead field in the voxel space analysis.

Designing a Low-Cost, Single-Supply ECG System for Suppression of Movement Artifact from Contaminated Magnetocardiogram.

Measurement of the late potentials and His-bundle activity is crucial for many clinical studies using the noncontact and noninvasive magnetocardiography (MCG) technique; these weak signals are extracted by averaging many cardiac cycles aligned using the R-peak of the cardiac cycle identified using an electrocardiography (ECG) lead. ECG is measured simultaneously with MCG using a conventional dual-supply ECG amplifier, which requires either two separate batteries or a single battery with a switching voltage inverter circuit for its proper operation. The ECG circuitry based on two separate batteries requires a relatively large voltage supply (-18 to +18 V). The single-supply (low voltage: 0-9 V) ECG circuitry may be implemented using a switching voltage inverter; however, this mode of operation introduces switching noise in the system. The objective of the present work is to overcome these problems by carefully designing a low-voltage, single-supply ECG system, which can be used simultaneously with the MCG setup without introducing a significant level of additional noise in the MCG measurement system.

A portable prototype magnetometer to differentiate ischemic and non-ischemic heart disease in patients with chest pain.

BACKGROUND: Magnetocardiography (MCG) is a non-invasive technique used to measure and map cardiac magnetic fields. We describe the predictive performance of a portable prototype magnetometer designed for use in acute and routine clinical settings. We assessed the predictive ability of the measurements derived from the magnetometer for the ruling-out of healthy subjects and patients whose chest pain has a non-ischemic origin from those with ischemic heart disease (IHD). METHODS: MCG data were analyzed from a technical performance study, a pilot clinical study, and a young healthy reference group. Participants were grouped to enable differentiation of those with IHD versus non-IHD versus controls: Group A (70 IHD patients); Group B (69 controls); Group C (37 young healthy volunteers). Scans were recorded in an unshielded room. Between-group differences were explored using analysis of variance. The ability of 10 candidate MCG predictors to predict normal/abnormal cases was analyzed using logistic regression. Predictive performance was internally validated using repeated five-fold cross-validation. RESULTS: Three MCG predictors showed a significant difference between patients and age-matched controls (P<0.001); eight predictors showed a significant difference between patients and young healthy volunteers (P<0.001). Logistic regression comparing patients with controls yielded a specificity of 35.0%, sensitivity of 95.4%, and negative predictive value for the ruling-out of IHD of 97.8% (area under the curve 0.78). CONCLUSION: This analysis represents a preliminary indication that the portable magnetometer can help rule-out healthy subjects and patients whose chest pain has a non-ischemic origin from those with IHD.

Magnetocardiography measurements with 4He vector optically pumped magnetometers at room temperature.

In this paper, we present a proof of concept study which demonstrates for the first time the possibility of recording magnetocardiography (MCG) signals with 4He vector optically pumped magnetometers (OPM) operated in a gradiometer mode. Resulting from a compromise between sensitivity, size and operability in a clinical environment, the developed magnetometers are based on the parametric resonance of helium in a zero magnetic field. Sensors are operated at room temperature and provide a tri-axis vector measurement of the magnetic field. Measured sensitivity is around 210 f T (√Hz)-1 in the bandwidth (2 Hz; 300 Hz). MCG signals from a phantom and two healthy subjects are successfully recorded. Human MCG data obtained with the OPMs are compared to reference electrocardiogram recordings: similar heart rates, shapes of the main patterns of the cardiac cycle (P/T waves, QRS complex) and QRS widths are obtained with both techniques.

Noninvasive Determination of HV Interval Using Magnetocardiography.

BACKGROUND: The His-ventricular (HV) interval is an important index of atrioventricular conduction, but at present can be reliably measured only during an invasive electrophysiology (EP) study. Magnetocardiography (MCG) is a noninvasive measurement of weak magnetic fields generated by the heart. We compared HV interval noninvasively assessed using MCG with the corresponding values measured directly in an EP study. METHODS: MCG was measured using a 37-channel system inside a magnetically shielded room in patients who had previously undergone an EP study. His-bundle potential was identified in the PR segment after signal averaging. Magnetic field maps representing the spatial distribution of ramp-like signals in the PR segment generated at various instants of time were used to identify His-bundle signals in cases where the deflection representing the His was ambiguous. RESULTS: The study included 23 patients (14 male, nine female) with a wide range of HV intervals measured during EP study (49 ± 17 ms, range 35-120 ms). In 21 (91%) subjects, discernible His-bundle signals are observed in the PR segment of MCG traces. HV intervals measured between the two methods showed a correlation (r2 = 0.87, P < 0.0001) with a mean difference of 5.4 ± 3.2 ms. CONCLUSION: With the use of new criteria to identify the His-bundle deflection in signal-averaged MCG signals, we report a high success rate in noninvasive HV interval measurement and a good agreement with those from EP study. The results encourage the use of MCG as a noninvasive method for measurement of the HV interval.

Fetal magnetocardiography using optically pumped magnetometers: a more adaptable and less expensive alternative?

Fetal magnetocardiography provides the requisite precision for diagnostic measurement of electrophysiological events in the fetal heart. Despite its significant benefits, this technique with current cryogenic based sensors has been limited to few centers, due to high cost of maintenance. In this study, we show that a less expensive non-cryogenic alternative, optically pumped magnetometers, can provide similar electrophysiological and quantitative characteristics when subjected to direct comparison with the current technology. Further research can potentially increase its clinical use for fetal magnetocardiography. © 2016 John Wiley & Sons, Ltd.

Three-dimensional reconstruction of a cardiac outline by magnetocardiography.

A 3-D cardiac visualization is significantly helpful toward clinical applications of magnetocardiography (MCG), but the cardiac reconstruction requires a segmentation process using additional image modalities. This paper proposes a 3-D cardiac outline reconstruction method using only MCG measurement data without further imaging techniques. The cardiac outline was reconstructed by a combination of both spatial filtering and coherence mapping method. The strength of cardiac activities was first estimated by the array-gain constraint minimum-norm spatial filter with recursively updated gram matrix (AGMN-RUG). Then, waveforms were reconstructed at whole source grids, and the maximum source points of an atrium and ventricle were selected as a reference, respectively. Next, the coherence between each maximum source point and whole source points was compared by the coherence mapping method. A reconstructed cardiac outline was validated by comparing with an overlapped volume ratio when the reconstructed volume was identically matched with the original volume. The results obtained by the AGMN-RUG were compared to the results by other spatial filters. The accuracy of numerical simulation and phantom experiment by the AGMN-RUG was superior 10% and 8%, respectively, than the accuracy by the standardized low-resolution electromagnetic tomography. This accuracy demonstrated the efficacy of the proposed 3-D cardiac reconstruction method.

[ECONOMIC EFFICIENCY TECHNOLOGIES DIAGNOSIS OF ISCHEMIC HEART DISEASE BY MAHNITOTOKARDIOHRAFIYI].

The article is devoted to clinical--economic analysis of modern diagnostic technology--magnetocardiography by analyzing the "cost-effectiveness". Economic effectiveness of diagnosis of coronary artery disease using magnetocardiography in terms of cost/effectivness is shown. The economicaly optimal sequence of several noninvasive methods for diagnosis of coronary artery disease is defined.

A compact, high performance atomic magnetometer for biomedical applications.

We present a highly sensitive room-temperature atomic magnetometer (AM), designed for use in biomedical applications. The magnetometer sensor head is only 2 × 2 × 5 cm3 and is constructed using readily available, low-cost optical components. The magnetic field resolution of the AM is <10 fT Hz­1/2, which is comparable to cryogenically cooled superconducting quantum interference device (SQUID) magnetometers. We present side-by-side comparisons between our AM and a SQUID magnetometer, and show that equally high quality magnetoencephalography and magnetocardiography recordings can be obtained using our AM.

Diagnostic value of magnetocardiography in coronary artery disease and cardiac arrhythmias: a review of clinical data.

Despite the availability of several advanced non-invasive diagnostic tests such as echocardiography and magnetic resonance imaging, electrocardiography (ECG) remains as the most widely used diagnostic technique in clinical cardiology. ECG detects electrical potentials that are generated by cardiac electrical activity. In addition to electrical potentials, the same electrical activity of the heart also induces magnetic fields. These extremely weak cardiac magnetic signals are detected by a non-invasive, contactless technique called magnetocardiography (MCG), which has been evaluated in a number of clinical studies for its usefulness in diagnosing heart diseases. We reviewed the basic principles, history and clinical data on the diagnostic role of MCG in coronary artery disease and cardiac arrhythmias.

Optical magnetometer array for fetal magnetocardiography.

We describe an array of spin-exchange-relaxation-free optical magnetometers designed for detection of fetal magnetocardiography (fMCG). The individual magnetometers are configured with a small volume with intense optical pumping, surrounded by a large pump-free region. Spin-polarized atoms that diffuse out of the optical pumping region precess in the ambient magnetic field and are detected by a probe laser. Four such magnetometers, at the corners of a 7 cm square, are configured for gradiometry by feeding back the output of one magnetometer to a field coil to null uniform magnetic field noise at frequencies up to 200 Hz. We present the first measurements of fMCG signals using an atomic magnetometer.

Human MCG measurements with a high-sensitivity potassium atomic magnetometer.

Measuring biomagnetic fields, such as magnetocardiograms (MCGs), is important for investigating biological functions. To address to this need, we developed an optically pumped atomic magnetometer. In this study, human MCGs were acquired using a potassium atomic magnetometer without any modulating systems. The sensitivity of the magnetometer is comparable to that of high-T(c) superconducting quantum interference devices (SQUIDs) and is sufficient for acquiring human MCGs. The activity of a human heart estimated from the MCG maps agrees well with that measured with SQUID magnetometers. Thus, our magnetometer produces reliable results, which demonstrate the potential of our atomic magnetometer for biomagnetic measurements.

Fetal magnetocardiography (fMCG): moving forward in the establishment of clinical reference data by advanced biomagnetic instrumentation and analysis.

Cardiotocography and echocardiography are currently standard for fetal heart monitoring. However, both do not provide adequate temporal resolution to measure fetal cardiac time intervals and detect arrhythmias, which can occur during normal sinus rhythm. Fetal magnetocardiography (fMCG) is a non-invasive technique measuring magnetic signals generated by fetal heart activity. Most fMCG devices are installed in research institutions limiting the implementation of this method in a clinical setting. Several institutions made a step forward by installing devices, in particular for fetal investigations, in hospital sites to evaluate the clinical benefit. Based on instrumentation differences which can affect signal quality, there is still no established reference database for fetal cardiac time intervals. A new magnetograph dedicated to fetal recordings was implemented with improved patient comfort. The setting was optimized to establish a standard. A total of 103 healthy fetuses starting as early as possible after the first trimester were recorded and fMCG values of cardiac time intervals were compared to former studies. Data allowed high and reliable detection for all fMCG components starting at 17 weeks. The data were comparable to fMCG multicenter studies, fetal electrocardiography and neonatal ECG results and could serve as a database of norm values for further investigation of fetal arrhythmias.

Percutaneous method for single-catheter multiple monophasic action potential recordings during magnetocardiographic mapping in spontaneously breathing rodents.

To test the feasibility of a novel method to combine magnetocardiographic (MCG) estimate of ventricular repolarization (VR) and multiple monophasic action potential (MultiMAP) recording in spontaneously breathing rodents with percutaneous sub-xyphoid epicardial placement of a MCG-compatible amagnetic catheter (AC), ten Wistar rats (WRs) and ten guinea pigs (GPs) were studied. Under fluoroscopic control, the AC was moved until four stable MAPs were recorded (fixed inter-electrode distance of 1.2 mm). 36-channel DC-SQUID (sensitivity 20 fT Hz(-½)) were used for MCG mapping. MAPs, differentially amplified (BW: DC-500 Hz), were digitized at 1 kHz. AC pacing provided local ventricular effective refractory period (VERP) estimate. MAP duration (MAPd) was measured at 50% and 90% levels of repolarization. Simultaneous MCG mapping and MultiMAP recording were successful in all animals. Average MAPd50% and MAPd90% were shorter in WRs than in GPs (26.4 ± 2.9 ms versus 110.6 ± 14.3 ms and 60.7 ± 5.4 ms versus 127.7 ± 15.3 ms, respectively). VERP was 51 ± 4.8 ms in WRs and 108.4 ± 12.9 ms in GPs, respectively. The MAP amplitude was 16.9 ± 4.5 in WRs and 16.2 ± 4.2 in GPs. MAP and MCG parameters of VR were in good agreement. All animals survived the procedure. Two also survived a second invasive study; one was followed up until natural death at 52 months. Percutaneous MultiMAP recording is minimally invasive, usually avoids animal sacrifice, is compatible with simultaneous surface MCG mapping and might be used for experimental validation of MCG VR abnormality, to study the arrhythmogenic potential of new drugs and/or animal models of ventricular arrhythmias.

Clinical application of magnetic mapping.

Noninvasive screening technique to identify cardiac disease in its early phase is developed. Magnetic imaging of cardiac action currents is a new and an ideally suited technology for testing the level of local electric heterogeneities of myocardium. Magnetocardiography has the potential to make a valuable contribution in basic examination and analysis of biosignals of a heart. in particular whilst all vector components are used, vast spatial coverage and excellent signal quality.