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Early diagnosis and localization of myocardial ischemia (MS) and coronary artery stenosis (CAS) play a crucial role in the effective prevention and management of ischemic heart disease (IHD). Magnetocardiography (MCG) has emerged as a promising approach for non-invasive, non-contact, and high-sensitivity assessment of cardiac dysfunction. This study presents a multi-center, AI-enabled diagnosis and localization of myocardial ischemia and coronary artery stenosis from MCG data. To this end, we collected a large-scale dataset consisting of 2,158 MCG recordings from eight clinical centers. We then proposed a multiscale vision transformer-based network for extracting spatio-temporal information from multichannel MCG recordings. Anatomical prior knowledge of the coronary artery and the irrigated left ventricular regions was incorporated by a carefully designed graph convolutional network (GCN)-based feature fusion module. The proposed approach achieved an accuracy of 84.7%, a sensitivity of 83.8%, and a specificity of 85.6% in diagnosing IHD, an average accuracy of 78.4% in localization of five MS regions, and an average accuracy of 65.3% in localization of stenosis in three coronary arteries. Subsequent validation on an independent validation dataset consisting of 268 MCG recordings collected from four clinical centers demonstrated an accuracy of 82.3%, a sensitivity of 83.8%, and a specificity of 81.3% in diagnosing IHD, an average accuracy of 77.3% in localization of five myocardial ischemic regions, and an average accuracy of 65.6% in localization of stenosis in three coronary arteries. The proposed approach can be used as a fast and accurate diagnosis tool, boosting the integration of MCG examination into clinical routine. [ABSTRACT FROM AUTHOR]

Abstract Fetal magnetocardiography (fMCG) is a non-invasive technique that measures the magnetic fields associated with fetal heart electrical activity outside of the maternal abdomen. fMCG has high temporal precision for measuring fetal heart rate and its variability which reflects fetal neurodevelopment. Free of cryogenics and low-cost sensors called microfabricated optically pumped magnetometers (OPMs) have emerged as an alternate to cryogenic SQUID (Superconducting Quantum Interference Device) systems to record fMCG. Previous research has demonstrated the ability of the OPMs to measure the fMCG at different maternal positions by taking the advantage of the conformal and geometric flexibility of the sensors. In this work, we designed and configured a bed-based stand-alone array of OPMs to obtain serial recordings of fMCG. 72 combined OPM-SQUID recordings were conducted at different gestational ages in 22 pregnant women. We were able to obtain fMCG with similar detectability as the gold standard SQUID from OPM sensors mounted on a novel belly-shape patient interface design with movable sensor holders. While additional translational research is needed, the outcome of this study can further facilitate the development of a non-cryogenic low-cost smaller footprint device to increase the use of OPMs for fetal research and clinical applications.

Introduction. The investigation of the electrical activity of the human heart by measuring electromagnetic signals is widely used in cardiodiagnostics. The use of magnetometric methods for diagnosing disorders of the heart is largely associated with the development of ultra-sensitive magnetometric equipment based on SQUIDs (SQUID-Superconducting QUantum Interference Device). The purpose. Magnetocardiography (MCG) is one of the promising methods for practical implementation. MCG is a method of non-invasive, electrophysiological investigation of the human heart. Investigation consists in non-contact, over the human chest registration of the values ??of the parameters of the magnetic field generated by the electrical activity of the myocardium during the cardiac cycle, reconstruction and analysis of the spatio-temporal characteristics of the electrical sources in the volume of the myocardium found after the development inverse problem solution. Results. In this paper, a new algorithm for the analysis of the results of non-contact measurement of the cardiomagnetic signal at observation points distributed in the plane above the human chest was developed. The time series of the signal values - "magnetocardiographic lead" (MCG lead) is matched to the measurement results. When constructing this integral characteristic of the cardiomagnetic signal, its spatial and temporal properties were used, which were found during the analysis of statistically significant groups of cardiomagnetic records (MCG of patients) for healthy volunteers. Conclusions. The proposed algorithm does not involve the magnetostatics inverse problem solution. To implement the method, procedures for normalization and standardization of the position of nodal points and durations of the corresponding time intervals of the averaged cardiocycles have been developed. An algorithm and criteria for selecting observation points for constructing the distribution of the integral characteristic have been developed. At each stage of data processing, the results obtained for statistically significant groups of real magnetocardiograms were analyzed. The results of the application of the method in solving the task of magnetocardiogram classification show high sensitivity, specificity, and stability of the proposed MCG analysis algorithm.

This review systematically analyzes the latest advancements in preprocessing techniques for Electrocardiography (ECG) and Magnetocardiography (MCG) signals over the past decade. ECG and MCG play crucial roles in cardiovascular disease (CVD) detection, but both are susceptible to noise interference. This paper categorizes and compares different ECG denoising methods based on noise types, such as baseline wander (BW), electromyographic noise (EMG), power line interference (PLI), and composite noise. It also examines the complexity of MCG signal denoising, highlighting the challenges posed by environmental and instrumental interference. This review is the first to systematically compare the characteristics of ECG and MCG signals, emphasizing their complementary nature. MCG holds significant potential for improving the precision of CVD clinical diagnosis. Additionally, it evaluates the limitations of current denoising methods in clinical applications and outlines future directions, including the potential of explainable neural networks, multi-task neural networks, and the combination of deep learning with traditional methods to enhance denoising performance and diagnostic accuracy. In summary, while traditional filtering techniques remain relevant, hybrid strategies combining machine learning offer substantial potential for advancing signal processing and clinical diagnostics. This review contributes to the field by providing a comprehensive framework for selecting and improving denoising techniques, better facilitating signal quality enhancement and the accuracy of CVD diagnostics. [ABSTRACT FROM AUTHOR]

Background: Magnetocardiography (MCG) is a novel non-invasive technique that detects subtle magnetic fields generated by cardiomyocyte electrical activity, offering sensitive detection of myocardial ischemia. This study aimed to assess the ability of MCG to predict impaired myocardial perfusion using single-photon emission computed tomography (SPECT). Methods: A total of 112 patients with chest pain underwent SPECT and MCG scans, from which 65 MCG output parameters were analyzed. Using least absolute shrinkage and selection operator (LASSO) regression to screen for significant MCG variables, three machine learning models were established to detect impaired myocardial perfusion: random forest (RF), decision tree (DT), and support vector machine (SVM). The diagnostic performance was evaluated based on the sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC). Results: Five variables, the ratio of magnetic field amplitude at R-peak and positive T-peak (RoART+), R and T-peak magnetic field angle (RTA), maximum magnetic field angle (MAmax), maximum change in current angle (CCAmax), and change positive pole point area between the T-wave beginning and peak (CPPPATbp), were selected from 65 automatic output parameters. RTA emerged as the most critical variable in the RF, DT, and SVM models. All three models exhibited excellent diagnostic performance, with AUCs of 0.796, 0.780, and 0.804, respectively. While all models showed high sensitivity (RF = 0.870, DT = 0.826, SVM = 0.913), their specificity was comparatively lower (RF = 0.500, DT = 0.300, SVM = 0.100). Conclusions: Machine learning models utilizing five key MCG variables successfully predicted impaired myocardial perfusion, as confirmed by SPECT. These findings underscore the potential of MCG as a promising future screening tool for detecting impaired myocardial perfusion. [ABSTRACT FROM AUTHOR]

Introduction: Coronary artery disease (CAD) is a leading cause of death and disability in developed countries. While exercise testing is recommended for diagnosing stable angina pectoris, its limited sensitivity and specificity have been questioned. Myocardial strain is a promising predictor of significant CAD. Aim: To evaluate the utility of myocardial strain obtained by 2D speckle tracking at rest and under stress combined with stress magnetocardiography for detecting CAD in patients with stable or low-risk unstable angina pectoris. Methods: A total of 108 patients meeting the inclusion criteria underwent coronary angiography within 48 h of admission. Myocardial strain was assessed using 2D speckle tracking at rest and during dobutamine stress alongside stress magnetocardiography. Results: Global longitudinal strain at stress showed a moderate correlation with significant CAD (r = 0.41, p <0.0001) and with coronary occlusion severity (r = 0.62, p <0.0001). Strain at stress had a sensitivity of 74.1% and specificity of 76.7% for detecting CAD at a cut-off value of −19.1. The ST fluctuation rate from magnetocardiography demonstrated the highest sensitivity for CAD detection. Conclusions: Longitudinal strain parameters and stress magnetocardiography are effective non-invasive methods for predicting CAD in patients with stable angina, potentially reducing the need for invasive assessments. [ABSTRACT FROM AUTHOR]

The chip-scale hybrid optical pumping spin-exchange relaxation-free (SERF) atomic magnetometer with a single-beam arrangement has prominent applications in biomagnetic measurements because of its outstanding features, including ultrahigh sensitivity, an enhanced signal-to-noise ratio, homogeneous spin polarization and a much simpler optical configuration than other devices. In this work, a miniaturized single-beam hybrid optical pumping SERF atomic magnetometer based on a microfabricated atomic vapor cell is demonstrated. Although the optically thin Cs atoms are spin-polarized, the dense Rb atoms determine the experimental results. The enhanced signal strength and narrowed resonance linewidth are experimentally proven, which shows the superiority of the proposed magnetometer scheme. By using a differential detection scheme, we effectively suppress optical noise with an approximate five-fold improvement. Moreover, the cell temperature markedly affects the performance of the magnetometer. We systematically investigate the effects of temperature on the magnetometer parameters. The theoretical basis for these effects is explained in detail. The developed miniaturized magnetometer has an optimal magnetic sensitivity of 20 fT/Hz1/2. The presented work provides a foundation for the chip-scale integration of ultrahighly sensitive quantum magnetometers that can be used for forward-looking magnetocardiography (MCG) and magnetoencephalography (MEG) applications. [ABSTRACT FROM AUTHOR]

Decades of research have shown that magnetocardiography (MCG) has the potential to improve cardiac care decisions. However, sensor and system limitations have prevented its widespread adoption in clinical practice. We report an MCG system built around an array of scalar, optically pumped magnetometers (OPMs) that effectively rejects ambient magnetic interference without magnetic shielding. We successfully used this system, in conjunction with custom hardware and noise rejection algorithms, to record magneto-cardiograms and functional magnetic field maps from 30 volunteers in a regular downtown office environment. This demonstrates the technical feasibility of deploying our device architecture at the point-of-care, a key step in making MCG usable in real-world settings. [ABSTRACT FROM AUTHOR]

This study aims to develop an automated method for de-noising cardiac signals using independent component analysis (ICA) on a 37-channel magnetocardiography (MCG) system. The traditional approach of applying ICA involves manual visual inspection to determine the retention or removal of independent component (IC) related to signal or noise, which is time-consuming and lacks assurance in preserving essential attributes of signal components during the de-noising process. To address these challenges, we propose a novel approach. A feature set comprising spectral, statistical, and nonlinear time series properties is computed from the ICs of thirty subjects. These features are then evaluated by a few machine learning (ML) models to optimally select ICs for de-noising cardiac time series. It is found that ICs evaluated by a gradient boosting decision tree (GBDT) classifier could accomplish the task of efficiently selecting components to de-noise MCG with an accuracy of 93%. The performance of the proposed method is qualitatively and quantitatively compared against conventional methods for noise elimination and preserving signal features. The proposed method has extensive application in de-noising multichannel MCG signals where the characteristics of the noise are not clearly known and for routine diagnostic assessments of subjects with cardiac anomalies in hospital settings. [ABSTRACT FROM AUTHOR]

The emergence of biomagnetism imaging has led to the development of ultrasensitive and compact spin-exchange relaxation-free (SERF) atomic magnetometers that promise high-resolution magnetocardiography (MCG) and magnetoencephalography (MEG). However, conventional optical components are not compatible with nanofabrication processes that enable the integration of atomic magnetometers on chips, especially for elliptically polarized laser-pumped SERF magnetometers with bulky optical systems. In this study, an elliptical-polarization pumping beam (at 795 nm) is achieved through a single-piece metasurface, which results in an SERF magnetometer with a high sensitivity reaching 10.61 fT/Hz1/2 by utilizing a 87Rb vapor cell with a 3 mm inner diameter. To achieve the optimum theoretical polarization, our design combines a computer-assisted optimization algorithm with an emerging metasurface design process. The metasurface is fabricated with 550 nm thick silicon-rich silicon nitride on a 2 × 2 cm2 SiO2 substrate and features a 22.17° ellipticity angle (a deviation from the target polarization of less than 2%) and more than 80% transmittance. This study provides a feasible approach for on-chip polarization control of future all-integrated atomic magnetometers, which will further pave the way for high-resolution biomagnetism imaging and portable atomic sensing applications. [ABSTRACT FROM AUTHOR]

Study objectives: Patients frequently present to the emergency department (ED) with chest pain requiring further risk stratification. Traditional cardiac diagnostics such as stress testing may expose patients to ionizing radiation, may not be readily available, may take significant time for testing and interpretation, and adds cost to the workup. Magnetocardiography (MCG) is an alternative approach to assess candidates more quickly and efficiently than routine downstream testing. Design: We created and ran 1000 trials of a Monte Carlo simulation. Using this simulation, we modeled the national annual impact by averting further cardiac diagnostics. Setting: All EDs in the United States. Participants: All ED adult patients with chest pain. Interventions: Simulated use of MCG to reduce avoidable downstream cardiac diagnostics. Main outcome measures: Our primary outcome was to estimate the impact of an MCG-first strategy on the annual national cost savings among eligible patients in the ED. Our secondary outcomes were the estimated reduction in short-stay hospitalizations, cancer cases, and cancer deaths due to radiation exposure. Results: An MCG-first strategy was estimated to save a mean (±SD) of $574 million (±$175 million) by avoiding 555,000 (±93,000) downstream cardiac diagnostic tests. This resulted in a national annual cumulative decrease of 500,000 (±84,000) hospitalizations, 7,600,000 (±1,500,000) bed hours, 409 (±110) new cancer diagnoses, and 210 (±56) new cancer deaths due to radiation exposure from avoidable cardiac diagnostics. Conclusions: If adopted widely and used consistently, an MCG-first strategy among eligible patients could yield substantial benefits by averting avoidable cardiac diagnostic testing.

Background: Magnetocardiography (MCG) may provide a rapid diagnostic option for patients presenting with chest pain in the emergency department (ED). Case summaries: This case series presents two instances from a multicenter study, where MCG could have served as a rapid, non-invasive diagnostic tool for chest pain patients. In both cases, multiple high-sensitivity troponin (hsTn) tests yielded incorrect evidence of ischemia. In the first case, multiple positive hsTn tests led to the patient requiring 23 h of observation care, while MCG rapidly ruled out acute coronary syndrome (ACS). In the second case, MCG revealed findings indicative of cardiac ischemia where serial ECGs did not indicate ischemia and serial hsTns were normal. Subsequent cardiac catheterization confirmed 99 % stenosis in the patient's left main and left anterior descending arteries, necessitating coronary artery bypass grafting (CABG). Conclusion: MCG offers a rapid, painless, non-invasive, radiation free assessment for patients presenting with acute chest pain. Integrating MCG into ED workflows has the potential to improve throughput, reduce the need for subsequent patient observation or inpatient admission, and minimize or eliminate the need for other more expensive non-invasive cardiac testing. MCG avoids some of the problems associated with other methods for diagnosing ischemia. MCG does not involve radiation or the use of pharmacologic agents which have a risk for allergic reactions and anaphylaxis, or the need for an intravenous line. Stress tests are frequently contraindicated or unable to be performed in patients on various medications, may require patient cooperation and in the case of exercise stress tests, the patient's capability to exercise. MCG requires no special patient preparation.

Background: In patients with angina and non-obstructive coronary artery disease (ANOCA), diagnosis of coronary microvascular dysfunction (CMD) remains an unmet need. Magnetocardiography (MCG), is a rest-based, non-invasive scan that can detect weak electrophysiological changes that occur at the early phase of ischemia. Objective: This study assessed the ability of MCG to detect CMD in ANOCA patients as compared to reference standard, invasive coronary flow reserve (CFR). Methods: Patients with ANOCA and invasive coronary physiologic assessment using intracoronary flow measurements with Doppler and thermodilution methods were enrolled. CMD was defined dichotomously as an invasive CFR

Background: The diagnosis of myocarditis remains challenging due to its diverse clinical manifestations. We recently demonstrated the ability of magnetocardiography (MCG) to screen for myocarditis and applied it successfully to detect myocarditis in this case study of a female-to-male (FtM) patient who had undergone sexual reassignment surgery. This case highlights two significant points: first, sex differences in myocarditis may be promoted by higher levels of testosterone, and second, the ability of MCG to diagnose myocarditis. Case presentation: We report on a 38-year-old FtM patient who was hospitalized for chest pain following testosterone therapy. The patient received testosterone every 2 weeks for 6 months following his FtM surgery. Two days after the last administration of testosterone, he developed chest pain. Electrocardiography identified non-significant ST elevations in V3–6, II and aVF and echocardiography revealed reduced left ventricular ejection fraction and apical hypokinesia. High-sensitivity troponin-T (539 ng/L to 676 ng/L) and creatine kinase elevation (592 U/L) were elevated. Coronary CT angiography ruled out coronary artery disease. Cardiac magnetic resonance imaging confirmed suspected myocarditis.Additionally, we used MCG to detect abnormalities in the electromagnetic field. A pathologic vector (0.179) supported the diagnosis of myocarditis in this patient. During therapy with ibuprofen the vector improved to 0.067 after 3 weeks accompanied by symptom improvement. Conclusion: Testosterone treatment may have promoted myocarditis in a FtM individual. Additional MCG assessment was consistent with a diagnosis of myocarditis and highlights the promising potential of this method to facilitate diagnostic screening for cardiomyopathy in the future.

Background: Diagnosing ischemia in emergency department (ED) patients with suspected acute coronary syndrome (sACS) is challenging with equivocal disposition of intermediate risk patients. Objective: Compare sensitivity and specificity of magnetocardiography (MCG) versus standard of care (SOC) stress testing in diagnosing myocardial ischemia. Methods: Multicenter, prospective, observational cohort study. ED patients with sACS and HEART score ≥ 3 underwent 90 s noninvasive MCG to detect myocardial ischemia. Results were blinded to the patient's clinicians. MCGs were read independently by 3 physicians blinded to clinical data. Myocardial ischemia was ≥70 % epicardial coronary artery stenosis, revascularization within 30 days, or 30-day major adverse cardiac events (MACE). Time to first test (TTT) and patient satisfaction for MCG and SOC were compared. Results: Of enrolled patients (N = 390) (mean age 59 ± 12 years, 45 % female), 99 (25 %) underwent a non-invasive stress test: 42 (14 %) diagnosed with ischemia. MCG sensitivity was 66.7 % (50.5–80.4 %, 95 % CI) and specificity 57.1 % (50.0–63.3 %, 95 % CI) for detecting coronary ischemia. Noninvasive stress testing (stress echo, nuclear stress, and exercise stress) had the same sensitivity 66.7 % (95 % CI 29.9 % to 92.5 %) and a specificity of 89.9 % (95 % CI 81.7–95.3 %). Mean TTT was shorter for MCG, 3.18 h (SD 1.91) vs. SOC stress testing 22.71 (SD 15.23), p

Optically pumped gradiometers have long been utilized in measurement in the International Geomagnetic Reference Field (IGRF). With advancements in technologies such as laser diodes and microfabrication, integrated gradiometers with compact sizes have become available, enabling improvements in magnetoencephalography and fetal magnetocardiography within shielded spaces. Moreover, there is a growing interest in the potential of achieving biomagnetic source detection without shielding. This review focuses on recent developments in optically pumped magnetic field gradiometers, including various fabrication methods and measurement schemes. The strengths and weaknesses of different types of optically pumped gradiometers are also analyzed. [ABSTRACT FROM AUTHOR]

Background: Fulminant myocarditis (FM) is associated with high mortality and an unfavorable long-term prognosis. However, noninvasive, rapid diagnostic and monitoring methods for FM are lacking. Case summary: This report details the case of a patient diagnosed with FM through a comprehensive assessment involving typical clinical symptoms, laboratory analyses, echocardiographic evidence, and cardiac magnetic resonance (CMR) findings. Before the patient underwent CMR, optical pumped magnetometer magnetocardiography (OPM-MCG) revealed abnormalities characteristic of substantial myocardial injury. After invasive coronary angiography, the patient's coronary arteries were determined not to exhibit significant stenosis. Additionally, a myocardial bridge was observed in the middle segment of the anterior descending branch of the left coronary artery. Over a 7-month follow-up, the patient's symptoms showed marked improvement, and the OPM-MCG eventually normalized, aligning with the findings indicated by the CMR. Conclusion: OPM-MCG is a valuable tool for therapy monitoring in FMs, offering a safe, non-invasive, and highly effective test for ancillary diagnostics and long-term prognostic follow-up. Additionally, MCG may potentially assist in clinical decision-making regarding the need for further interventions in patients with myocardial bridge. [ABSTRACT FROM AUTHOR]

This article presents a review of domestic research on the development of new medical equipment and technologies using equipment and methods of detection of natural magnetic fields of biological objects. The core of the biomagnetic research technology consists of noncontact detection, special mathematical processing, and analysis of the values of the parameters of the magnetic field of the investigated bioobject (generated by the heart, brain, muscles, etc.) found in the specified points of space outside the body of the bioobject using highly sensitive magnetometer equipment, and in particular, using superconducting quantum interference devices (SQUIDs). Based on the studies of myocardial electrophysiology, the samples of technical solutions of magnetometric SQUID-systems for magnetocardiography (MCG), data on diagnostic capabilities, and prospects of practical application of MCG in cardiology are presented. The methodology of magnetocardiographic examination is described and the advantages of MCG application for early diagnosis and control of therapy of various cardiovascular diseases (CVDs) are described. The work of the software of MAG-SCAN diagnostic complexes for the analysis of magnetocardiosignals is illustrated by solving the problem of classifying groups of cardiological patients. [ABSTRACT FROM AUTHOR]

The weak-value-amplification (WVA) effect, which is also called weak measurement, has been developed extensively in various sensing systems. Here, we report the actual realization of the WVA effect in spin-exchange relaxation-free atomic magnetometer system, wherein the slight separation of transverse momentum of the probe light is amplified by introducing orthogonal pre- and post-selection states. A differential detector is used to obtain the transverse position of the probe light accurately in real time. The weak coupling of the magneto-optical interaction with atoms will be reflected in the differential signal. The WVA effect is observed and demonstrated directly and a high sensitivity of 8 fT / H z is achieved. Also, we obtain the stable and distinct simulated magnetocardiography signal through our system. The present successful implementation of this probe method paves the way for further technical noise suppression and sensitivity improvement of quantum sensors. [ABSTRACT FROM AUTHOR]

Despite encouraging advances in early diagnosis and treatment, cardiovascular diseases (CVDs) remained a leading cause of morbidity and mortality worldwide. Increasing evidence has shown that the electromagnetic field (EMF) influences many biological processes, which has attracted much attention for its potential therapeutic and diagnostic modalities in multiple diseases, such as musculoskeletal disorders and neurodegenerative diseases. Nonionizing EMF has been studied as a therapeutic or diagnostic tool in CVDs. In this review, we summarize the current literature ranging from in vitro to clinical studies focusing on the therapeutic potential (external EMF) and diagnostic potential (internal EMF generated from the heart) of EMF in CVDs. First, we provided an overview of the therapeutic potential of EMF and associated mechanisms in the context of CVDs, including cardiac arrhythmia, myocardial ischemia, atherosclerosis, and hypertension. Furthermore, we investigated the diagnostic and predictive value of magnetocardiography in CVDs. Finally, we discussed the critical steps necessary to translate this promising approach into clinical practice. [ABSTRACT FROM AUTHOR]

ObjectivesThis study sought to determine the relationship between long QT syndrome (LQTS) subtype (LTQ1, LTQ2, LTQ3) and postnatal cardiac events (CEs).BackgroundLQTS presenting with 2:1 atrioventricular block or torsades de pointes in the fetus and/or neonate has been associated with risk for major CEs, but overall outcomes and predictors remain unknown.MethodsA retrospective study involving 25 international centers evaluated the course of fetuses/newborns diagnosed with congenital LQTS and either 2:1 atrioventricular block or torsades de pointes. The primary outcomes were age at first CE after dismissal from the newborn hospitalization and death and/or cardiac transplantation during follow-up. CE was defined as aborted cardiac arrest, appropriate shock from implantable cardioverter-defibrillator, or sudden cardiac death.ResultsA total of 84 fetuses and/or neonates were identified with LQTS (12 as LQT1, 35 as LQT2, 37 as LQT3). Median gestational age at delivery was 37 weeks (interquartile range: 35 to 39 weeks) and age at hospital discharge was 3 weeks (interquartile range: 2 to 5 weeks). Fetal demise occurred in 2 and pre-discharge death in 1. Over a median of 5.2 years, there were 1 LQT1, 3 LQT2, and 23 LQT3 CEs (13 aborted cardiac arrests, 5 sudden cardiac deaths, and 9 appropriate shocks). One patient with LQT1 and 11 patients with LQT3 died or received cardiac transplant during follow-up. The only multivariate predictor of post-discharge CEs was LQT3 status (LQT3 vs. LQT2: hazard ratio: 8.4; 95% confidence interval: 2.6 to 38.9; p

IntroductionSudden cardiac arrest is a major cause of morbidity and mortality worldwide and remains a major public health problem for which better non-invasive prediction tools are needed. Primary preventive therapies, such as implantable cardioverter defibrillators, are not personalized and not predictive. Most of these devices do not deliver life-saving therapy during their lifetime. The individual relationship between fatal arrhythmias and cardiac function abnormalities in predicting cardiac death risk has rarely been explored.MethodsWe retrospectively analyzed the measurements at rest for 191 patients with acute chest pain (ACP) magnetocardiographically. Our recently introduced analyses are able to detect inhomogeneities of the depolarization and repolarization. Moreover, electrically silent phenomena—intracellular ionic currents as well as vortex currents—can be measured and quantified. All included ACP patients were recruited in 2009 at Yonsei University Hospital and were followed up until 2022.ResultsDuring half of the follow-up period (6.5 years), 11 patients died. Out of all the included nine clinical, eight magnetocardiographical, and nine newly introduced magnetoionographical parameters we tested in this study, three parameters revealed themselves to be outstanding at predicting death: heart rate-corrected QT (QTc) prolongation, depression of repolarization current IKr + IKs, and serum creatinine (all significant in Cox regression, p

Background: Invasive recording of His bundle signals (HBS) in electrophysiological study (EPS) is important in determining HV interval, the time taken to activate the ventricles from the His bundle. Noninvasive surface measurements of HBS are attempted by averaging typically 100–200 cardiac cycles of ECG time series in body surface potential mapping (BSPM) and in magnetocardiography (MCG) which records weak cardiac magnetic fields by highly sensitive detectors. However, noninvasive beat‐by‐beat extraction of HBS is challenged by ramp‐like atrial signals and noise in PR segment of the cardiac cycle. Methods: By making use of a signal‐averaged trace showing prominent HBS as a guide trace, we developed a method combining interval‐dependent wavelet thresholding (IDWT) and signal space projection (SSP) technique to eliminate artifacts from single beats. The method was applied on MCG recorded on 21 subjects with known HV intervals based on EPS and noninvasive signal‐averaging, including five subjects with BSPM recorded subsequently. The method was also applied on stress‐MCG of a subject featuring autonomic dynamics. Results: HBS could be extracted from 19 out of 21 subjects by signal‐averaging whose timing differed from EPS between −8 and 11 ms as tested by 2 observers. HBS in single beats were seen as aligned patterns in inter‐beat contours and were appreciable in stress‐MCG and conspicuous than BSPM. The performance of the method was evaluated on simulated and measured MCG to be adequate if the signal‐to‐noise ratio was at least 20 dB. Conclusions: These results suggest the use of this method for noninvasive assessments on HBS. [ABSTRACT FROM AUTHOR]

Using spin‐exchange relaxation‐free (SERF) atomic magnetometer array (AMA) in magnetocardiography and magnetoencephalography has presented a challenge in reducing its packing volume for integrated instrumentation and convenient maintenance. This study presents a novel, space‐saving SERF AMA based on an 8‐channel planar lightwave circuit (PLC) waveguide splitter with a compact footprint of 26 × 2.5 mm2. The PLC splitting configuration allows the synchronization of the pump for a multisensor array, resulting in highly consistent performance among the sensors, with an impressive ultrahigh sensitivity of 34 fT Hz−1/2 within a measurement bandwidth of 105 Hz. The PLC splitting method shows great promise in expanding the channel capacity of small‐scale SERF AMAs, offering a cost‐effective method for high‐resolution medical diagnoses through functional magnetic imaging of humans. In addition, this method is expected to find applications in fields such as electromagnetic induction imaging, biological magnetism, and geomagnetic observation. [ABSTRACT FROM AUTHOR]

In this paper, a novel way of choosing the initial estimates for solving magnetocardiographic inverse problems using the pattern search method is reported. As opposed to the conventional choice of pseudo random numbers, the co-ordinates of the maximum spatial gradient of magnetic fields across sensor locations were used as initial estimates for pattern search method with the help of current density maps. The proposed method has been extensively validated by computer simulation and test coil localization before applying to real magnetocardiogram of a few healthy subjects and those with a known conduction anomaly and ischemic heart disease. [ABSTRACT FROM AUTHOR]

Abstract Background Invasive recording of His bundle signals (HBS) in electrophysiological study (EPS) is important in determining HV interval, the time taken to activate the ventricles from the His bundle. Noninvasive surface measurements of HBS are attempted by averaging typically 100–200 cardiac cycles of ECG time series in body surface potential mapping (BSPM) and in magnetocardiography (MCG) which records weak cardiac magnetic fields by highly sensitive detectors. However, noninvasive beat‐by‐beat extraction of HBS is challenged by ramp‐like atrial signals and noise in PR segment of the cardiac cycle. Methods By making use of a signal‐averaged trace showing prominent HBS as a guide trace, we developed a method combining interval‐dependent wavelet thresholding (IDWT) and signal space projection (SSP) technique to eliminate artifacts from single beats. The method was applied on MCG recorded on 21 subjects with known HV intervals based on EPS and noninvasive signal‐averaging, including five subjects with BSPM recorded subsequently. The method was also applied on stress‐MCG of a subject featuring autonomic dynamics. Results HBS could be extracted from 19 out of 21 subjects by signal‐averaging whose timing differed from EPS between −8 and 11 ms as tested by 2 observers. HBS in single beats were seen as aligned patterns in inter‐beat contours and were appreciable in stress‐MCG and conspicuous than BSPM. The performance of the method was evaluated on simulated and measured MCG to be adequate if the signal‐to‐noise ratio was at least 20 dB. Conclusions These results suggest the use of this method for noninvasive assessments on HBS.

BackgroundThe diagnosis of inflammatory cardiomyopathies remains challenging. Life-threatening conditions such as acute coronary syndrome (ACS) always have to be considered as differential diagnoses due to similarities in presentation. Diagnostic methods for inflammatory cardiomyopathy include endomyocardial biopsy (EMB), cardiac magnetic resonance imaging (CMR), and positron emission tomography-computed tomography (PET-CT). We report a case in whom magnetocardiography (MCG) led to an initial diagnosis of inflammatory cardiomyopathy and in whom MCG was used for subsequent monitoring of treatment response under immunosuppression.Case presentationA 53-year-old man presented with two recurrent episodes of inflammatory cardiomyopathy within a 2-year period. The patient initially presented with reduced exercise capacity. Echocardiography revealed a moderately reduced left ventricular ejection fraction (LVEF 40%). Coronary angiography ruled out obstructive coronary artery disease (CAD) and an EMB was performed. The EMB revealed inflammatory cardiomyopathy without viral pathogens or replication. Moreover, we performed MCG, which confirmed a pathological Tbeg-Tmax vector of 0.108. We recently established a cutoff value of Tbeg-Tmax of 0.051 or greater for the diagnosis of inflammatory cardiomyopathy. Immunosuppressive therapy with prednisolone was initiated, resulting in clinical improvement and an LVEF increase from 40% to 45% within 1 month. Furthermore, the MCG vector improved to 0.036, which is considered normal based on our previous findings. The patient remained clinically stable for 23 months. During a routine follow-up, MCG revealed an abnormal Tbeg-Tmax vector of 0.069. The patient underwent additional testing including routine laboratory values, echocardiography (LVEF 35%), and PET-CT. PET-CT revealed increased metabolism in the myocardium—primarily in the lateral wall. Therapy with prednisolone and azathioprine was initiated and MCG was used to monitor the effect of immunosuppressive therapy.ConclusionIn addition to diagnostic screening, MCG has the potential to become a valuable method for surveillance monitoring of patients who have completed treatment for inflammatory cardiomyopathy. Furthermore, it could be used for treatment monitoring. While changes in the magnetic vector of the heart are not specific to inflammatory cardiomyopathy, as they may also occur in other types of cardiomyopathies, MCG offers a tool of broad and efficient diagnostic screening for cardiac pathologies without side effects.

Amyloidosis is characterized by a disorder of protein conformation and metabolism, resulting in deposits of insoluble fibrils in various organs causing functional disturbances. Amyloidosis can also affect the heart. Cardiac amyloidosis tends to have a poor prognostic outcome if diagnosed at a late stage. Therefore, early diagnosis and initiation of therapy as well as monitoring of treatment response are crucial to improve outcomes and to learn more about its pathophysiology and clinical course. We present an 83-year-old woman with cardiac transthyretin amyloidosis (ATTR) who was treated with tafamidis. The patient significantly improved 18 months after initiation of therapy with regards to exercise capacity and quality of life. In addition to standard diagnostic methods, we used magnetocardiography (MCG) to monitor potential treatment response by detecting changes in the magnetic field of the heart. MCG is a non-invasive method that detects the cardiac magnetic field generated by electrical currents in the heart with high sensitivity. We have recently shown that this magnetic field changes in various types of cardiomyopathies may be used as a non-invasive screening tool. We determined previously that an MCG vector ≥0.052 was the optimal threshold to detect cardiac amyloidosis. The patient's MCG was measured at various time points during therapy. At the time of diagnosis, the patient's MCG vector was 0.052. After starting therapy, the MCG vector increased to 0.090, but improved to 0.037 after 4 months of therapy. The MCG vector reached a value of 0.017 after 5 months of therapy with tafamidis, and then increased slightly after 27 months to a value of 0.027 (

Ischemic heart disease (IHD) continues to be a significant global public health concern and ranks among the leading causes of mortality worldwide. However, the identification of myocardial ischemia in patients suspected of having coronary artery disease (CAD) remains a challenging issue. Functional or stress testing is widely recognized as the gold standard method for diagnosing myocardial ischemia, but it is hindered by low diagnostic accuracy and limitations such as radiation exposure. Magnetocardiography (MCG) is a non-contact, non-invasive method that records magnetic fields produced by the electrical activity of the heart. Unlike electrocardiography (EKG) and other functional or stress testing, MCG offers numerous advantages. It is highly sensitive and can detect early signs of myocardial ischemia that may be missed by other diagnostic tools. This review aims to provide an extensive overview of the available evidence that establishes the utility of MCG as a valuable diagnostic tool for identifying myocardial ischemia, accompanied by a discussion of potential future research directions in this domain.

We demonstrate a magnetocardiography (MCG) sensor that operates in non-shielded environments, in real-time, and without the need for an accompanying device to identify the cardiac cycles for averaging. We further validate the sensor's performance on human subjects. Our approach integrates seven (7) coils, previously optimized for maximum sensitivity, into a coil array. Based on Faraday's law, magnetic flux from the heart is translated into voltage across the coils. By leveraging digital signal processing (DSP), namely, bandpass filtering and averaging across coils, MCG can be retrieved in real-time. Our coil array can monitor real-time human MCG with clear QRS complexes in non-shielded environments. Intra- and inter-subject variability tests confirm repeatability and accuracy comparable to gold-standard electrocardiography (ECG), viz., a cardiac cycle detection accuracy of >99.13% and averaged R-R interval accuracy of <5.8 ms. Our results confirm the feasibility of real-time R-peak detection using the MCG sensor, as well as the ability to retrieve the full MCG spectrum as based upon the averaging of cycles identified via the MCG sensor itself. This work provides new insights into the development of accessible, miniaturized, safe, and low-cost MCG tools. [ABSTRACT FROM AUTHOR]

Introduction: Fetal magnetocardiography (fMCG) is considered the best technique for diagnosis of fetal arrhythmia. It is superior to more widely used methods such as fetal, fetal electrocardiography, and cardiotocography for evaluation of fetal rhythm. The combination of fMCG and fetal echocardiography can provide a more comprehensive evaluation of fetal cardiac rhythm and function than is currently possible. In this study, we demonstrate a practical fMCG system based on optically pumped magnetometers (OPMs). Methods: Seven pregnant women with uncomplicated pregnancies underwent fMCG at 26–36 weeks' gestation. The recordings were made using an OPM-based fMCG system and a person-sized magnetic shield. The shield is much smaller than a shielded room and provides easy access with a large opening that allows the pregnant woman to lie comfortably in a prone position. Results: The data show no significant loss of quality compared to data acquired in a shielded room. Measurements of standard cardiac time intervals yielded the following results: PR = 104 ± 6 ms, QRS = 52.6 ± 1.5 ms, and QTc = 387 ± 19 ms. These results are compatible with those from prior studies performed using superconducting quantum interference device (SQUID) fMCG systems. Conclusions: To our knowledge, this is the first European fMCG device with OPM technology commissioned for basic research in a pediatric cardiology unit. We demonstrated a patient-friendly, comfortable, and open fMCG system. The data yielded consistent cardiac intervals, measured from time-averaged waveforms, compatible with published SQUID and OPM data. This is an important step toward making the method widely accessible. [ABSTRACT FROM AUTHOR]

Heart rate variability assessment of neonates of pregestational diabetic mothers have shown alterations in the autonomic nervous system (ANS). The objective was to study the effect of maternal pregestational diabetes on ANS at the fetal stage by combining cardiac and movement parameters using a non‐invasive fetal magnetocardiography (fMCG) technique. This is an observational study with 40 participants where fetuses from a group of 9 Type 1, 19 Type 2 diabetic, and 12 non‐diabetic pregnant women were included. Time and frequency domain fetal heart rate variability (fHRV) and coupling of movement and heart rate acceleration parameters related to fetal ANS were analyzed. Group differences were investigated using analysis of covariance to adjust for gestational age (GA). When compared to non‐diabetics, the Type 1 diabetics had a 65% increase in average ratio of very low‐frequency (VLF) to low‐frequency (LF) bands and 63% average decrease in coupling index after adjusting for GA. Comparing Type 2 diabetics to non‐diabetics, there was an average decrease in the VLF (50%) and LF bands (63%). Diabetics with poor glycemic control had a higher average VLF/LF (49%) than diabetics with good glycemic control. No significant changes at p < 0.05 were observed in high‐frequency (HF) frequency domain parameters or their ratios, or in the time domain. Fetuses of pregestational diabetic mothers exhibited some differences in fHRV frequency domain and heart rate‐movement coupling when compared to non‐diabetics but the effect of fHRV related to fetal ANS and sympathovagal balance were not as conclusive as observed in the neonates of pregestational diabetic mothers. [ABSTRACT FROM AUTHOR]

Fetal magnetocardiography (fMCG) has proven to be an important tool for the prenatal monitoring of electrical cardiac activity; however, the high cost of superconducting quantum instrumentation (SQUID) poses a limitation for the dissemination of fMCG as a routine clinical technique. Recently, optically pumped magnetometers (OPMs) operating within person-sized, cylindrical shields have made fMCG more practical, but environmental magnetic interference entering through the shield opening substantially degrades the quality of fMCG signals. The goal of this study was to further attenuate these interferences by placing the OPM array within a small ferrite shield. FMCG recordings were made with and without the ferrite shield in ten subjects inside a person-sized, three-layer mu-metal cylindrical shield. Although the fetal signal was slightly attenuated, the environmental interference was reduced substantially, and maternal interference was also diminished. This increased the signal-to-noise ratio significantly and improved the resolution of the smaller waveform components. The performance improvement was highest in the axial direction and compensated for a major weakness of open-ended, person-sized shields. The ferrite shield is especially beneficial for the deployment of triaxial OPM sensors, which require effective shielding in all directions. [ABSTRACT FROM AUTHOR]

Magnetocardiography (MCG) and electrocardiography (ECG) are noninvasive techniques that reflect cardiac electrical activity. Combined MCG and ECG (MECG) integrates both measurements, and due to technological advancements, vector MCG (vMCG) is now possible. Although all four modes—MCG, ECG, MECG, and vMCG—are used in cardiac source imaging, their spatial resolutions have not been systematically studied. This study evaluates these modes using a resolution matrix based on a realistic multi-tissue human model, analyzing their dependence on source direction, location, and signal-to-noise ratio. Results show that MECG and vMCG significantly reduce dependence on these factors, with vMCG offering superior spatial resolution. However, its advantage lessens as SNR decreases. Our findings suggest that MECG and vMCG enhance spatial resolution in cardiac source imaging, making them promising options for future research. • A comprehensive study of vector magnetocardiography source imaging from the perspective of spatial resolution is conducted for the first time using a realistic multi-tissue human model. • The spatial resolutions of four measurement modes are investigated, including single-component magnetocardiography, electrocardiography, magnetocardiography-electrocardiography combination, and vector magnetocardiography. • The spatial resolution is analyzed in terms of its dependence on the source direction, location, and signal-to-noise ratio, with the source direction determined using the gain matrices of magnetocardiography and electrocardiography. • A systematic framework is proposed to analyze factors influencing cardiac source imaging, focusing on the effects of source direction, position, and signal-to-noise ratio on spatial resolution. [ABSTRACT FROM AUTHOR]

Wearable magnetocardiography (MCG) systems offer advantages such as flexible sensor distribution and higher signal strength than that of traditional rigid cardiac systems. However, the flexible nature of wearable cardiac magnetic systems presents challenges in acquiring accurate optically pumped magnetometer sensor positions and orientations. In this study, we developed a sensor-positioning indicator cap (SPIC) system. The SPIC used point-cloud data acquired through a structured light scanner to extract the three-axis orientations and positions of the sensors. Additionally, we proposed a novel combined branch and bound iterative closest point algorithm, which eliminates the need for initial alignment. Without requiring additional fiducial markers on the subject's body, the sensors were registered in the computed tomography (CT) coordinate system based on the clavicular region. We designed and fabricated a reference phantom with known sensor positions and orientations to evaluate the accuracy of our method. Experimental results demonstrated that after registration, the average position error for all sensors < 1 mm , with an average orientation error < 1 °. In addition, we conducted simulations to assess the impact of registration errors on MCG source localization. The results indicated that errors resulting from our proposed registration method would introduce an approximately 1 mm error in source localization. This study introduces a registration method facilitating the reusability of CT data in wearable MCG systems, thereby benefiting research in MCG source localization. [ABSTRACT FROM AUTHOR]

• Recent improvements in the design of magnetocardiographic measurement systems make it possible to implement small, relatively nonexpensive MCG scanners in ordinary, unshielded, medium-sized rooms directly inside clinical departments, • Magnetocardiographic examination in the real clinical situation is expected to answer the following fundamental questions: (1) Are chest pain and other related symptoms associated with heart pathology, i.e., cardiogenic? (2) If yes, how severe is this pathology? (3) If these symptoms are cardiogenic, are they associated only with coronary artery disease or other heart diseases? • Both visual evaluation of sets of CDV maps and automatic decision rules based on linear discriminant analysis are applied for assessing the degree of abnormality. • The pattern recognition method based on the k-nearest neighbor rule is applied for differential diagnosis of the MCG results. • The techniques are described for localizing the pathological changes in the myocardium based on three-dimensional visualization of the inverse problem solution. Magnetocardiography undoubtedly has exceptionally high sensitivity to electrophysiological changes in the myocardium. This is an absolutely non-invasivemethod with no contraindications. However, several barriers exist to the widespread adoption of this technique into clinical routine. One of the most important is the lack of a clear and consistent medical algorithm for interpreting magnetocardiographic data, leading to a clinically significant decision. The article outlines the main clinical questions clinicians pose using the magnetocardiography method. Methods for assessing the degree of abnormality of the results of a magnetocardiographic study and differential diagnosis based on the analysis of CDV maps are described in detail. Both methods for visual evaluation of sets of these maps and automatic decision rules based on linear discriminant analysis and pattern recognition are characterized. Also, techniques are described for localizing the pathological changes in the myocardium. As an example of using the developed system for interpreting magnetocardiographic data, the results of two multicenter studies in which this system of interpretation of MCG studies was used are presented. The magnetocardiographic examination is reliable for diagnosing chronic coronary heart disease, including in difficult-to-diagnose cases. A consistent system for interpreting of magnetocardiographic data allows medical practitioners to easily master the MCG technology and obtain the correct examination result. [ABSTRACT FROM AUTHOR]

With the help of an extremely sensitive magnetic sensors array, magnetocardiography (MCG) can record magnetic field signals produced by the cardiac electrical activity. However, MCG is a very weak magnetic field signal, and tends to be overwhelmed by unsuppressed ambient magnetic noise. To address this issue, this work proposed a multi-channel MCG signals synchronously denoising method based on multivariate variational mode decomposition (MVMD) algorithm. Firstly, the MVMD algorithm extracted spatiotemporal correlation among channels and decomposed multi-channel signals into three-dimensional intrinsic mode functions (IMFs) matrix. By analyzing the time and frequency characteristics of each IMF, we figured out powerline interference (PLI), baseline wander (BW), and white Gauss noise (WGN), and then the sub-band filters removed the noise components before reconstruction. The correlation of three types of noises and MCG signals between channels were totally explored, and both simulated and experimental datasets verified the efficiency. The simulated results indicated that the average reconstruction error of the MCG signals is less than 1 pT. In the human MCG experiment, PLI and BW were reduced by approximately 60 dB and 20 dB, respectively, making the Q, R, and S waves clearly visible. Our work offers comprehensive solutions for denoising multi-channel MCG signals and significantly improves the denoising accuracy. • Synchronous filtering method for multi-channel MCG signals. • Introduction of spatiotemporal correlation among channels improves the accuracy of mode decomposition. • A comprehensive denoising method for MCG signals obtained from gradiometer or magnetic sensors array. [ABSTRACT FROM AUTHOR]

Introduction. Superconducting magnetometers based on SQUIDs (SQUID- Superconducting QUantum Interference Device) are currently used to register weak magnetic fields generated in various human organs and measured outside the body (in the environment). The creation of information technology, which is a set of methods and software tools combined into a technological chain that ensures registration, storage, pre-processing, analysis of measurement data and automatic diagnostic output, is an essential science-intensive component that determines the possibilities and success of the applied use of non-contact diagnostic systems of the human heart The purpose. Article presents new algorithms for spatial analysis of cardiomagnetic signal measurement results. The algorithms are based on the inverse problem solution, when the magnetic field source is matched to the spatial distribution of the magnetic signal and the parameters and spatial configuration of the source are determined. A model of the cardiomagnetic source was used in the form of a system of current density vectors, which are distributed in a plane that is parallel to the measurement plane and crosses the volume of the heart. Results. The inverse problem is solved using the apparatus of two-dimensional integral Fourier transformations. The data transformation algorithm allows to correctly take into account the design of the magnetic flux transformer (the dimensions of the pickup coils, their spatial location and the electrical connection scheme). Algorithm modifications have been developed for most of the known (implemented in existing magnetocardiographs) designs of magnetic flux transformers of the first and second order gradientometers. The operation of the algorithm is modeled on real data of magnetometric investigations of the human heart. Investigations have shown that the application of the proposed algorithms allows obtaining new information about the spatial configuration of the magnetic signal source in the human heart, which can be used in the future for the diagnosis of human heart diseases.

The article presents a study which introduced a movable magnetocardiography (MCG) system that can clearly record MCG signals of freely be-having participants in an unshielded environment. Topics discussed include unshielded MCG system in a moving platform, self-oscillating cesium magnetometer, and larmor frequency estimation.