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Detection of atrial arrhythmia in superconducting quantum interference device magnetocardiography; preliminary result of a totally-noninvasive localization method for atrial current mapping

^a Department of Thoracic and Cardio-vascular Surgery, Seoul Veterans Hospital, 6-2 Dunchon-dong Kangdong-gu, Seoul, 134-060, Korea
^b Department of Thoracic and Cardio-vascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
^c Bio-signal Research Center, Korea Research Institute of Standards and Science, Daejeon, Korea

*Corresponding author. Tel.: +82-2-2225-1346; fax: +82-2-477-5605.

E-mail address: mdksr{at}paran.com; mdksr{at}lycos.co.kr (D. Kim).

Map-guided surgery is the goal for treatment of atrial fibrillation (AF), because it minimizes unnecessary incisions or procedures. We propose a totally-noninvasive and even non-contact method to detect atrial arrhythmia with a superconducting quantum interference device magnetocardiography (MCG) system, and report the first clinical application case of MCG map-guided AF surgery. To detect weak atrial excitation, we utilized a high sensitive 64-channel MCG system measuring tangential magnetic field components, which is known to be more sensitive to a deeper current source. We measured the MCG signals from eight patients with chronic AF. Then, we separated the f-wave from the other components by using independent component analysis. The extracted f-wave caused by reentrant myocardial excitation was three-dimensionally localized on the mesh model of a human heart by a novel beamformer technique having a surface action potential activity as its filter output. We localized the abnormal stimulation source of an atrial arrhythmia non-invasively and visualized the current source distribution corresponding to the atrial excitation successfully on the three-dimensional atrial surface, which was separated from the ventricular excitation. Using this atrial mapping, we underwent minimal AF surgery in three patients and converted their AF to sinus rhythm successfully.

Key Words: Atrial fibrillation; Magnetocardiography; Map-guided surgery