Magnetocardiography detects left atrial dysfunction in paroxysmal atrial fibrillation

Article type: Research Article

Authors: Her, Ae-Young^a | Shin, Eun-Seok^{b; *} | Zhou, Qing^c | Wierzbinski, Jan^d | Vidal-Lopez, Silvia^d | Saleh, Ahmed^c | Kim, Yong Hoon^a | Garg, Scot^e | Jung, Friedrich^f | Brachmann, Johannes^c

Affiliations: [a] Department of Internal Medicine, Division of Cardiology, Kangwon National University School of Medicine, Chuncheon, South Korea | [b] Division of Cardiology, Ulsan Medical Center, Ulsan Hospital, Ulsan, South Korea | [c] Department of Medical II., Coburg Hospital, Coburg, Germany | [d] Department of Cardiology, Asklepios Hospital Harburg, Hamburg, Germany | [e] East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, UK | [f] Institute for Clinical Hemostasiology and Transfusion Medicine, University of Saarland, Saarbrücken, Germany

Correspondence: [*] Corresponding author: Eun-Seok Shin, MD, PhD, 13, Wolpyeong-ro, 171beon-gil, Nam-gu, Ulsan, 44033, South Korea. Tel.: +82 52 259 5425; E-mail: [email protected].

Abstract: BACKGROUND:Magnetocardiography (MCG) is a non-invasive technique and to characterize the magnetic field, a pseudo-current conversion was used. The role of MCG in detecting left atrial (LA) dysfunction in patients with paroxysmal atrial fibrillation (PAF) is unknown. OBJECTIVE:The aim of this study was to evaluate LA function using MCG in patients with PAF and healthy subjects, to identify possible indices to diagnose PAF. METHODS:We enrolled a total of 70 subjects including 26 healthy volunteers (group 1) and 22 marathon runners (group 2) who did not exhibit any cardiac abnormalities, and 22 patients with PAF (group 3) which was documented by electrocardiography (ECG). Spatiotemporal activation graph (STAG) in base-apex and left-right direction was reconstructed. The maximum value of LA pseudo-current under rest and peak exercise were measured between the end of the P wave and beginning of the Q wave. RESULTS:LA pseudo-current increase at peak exercise in PAF patients was significantly lower than in healthy volunteers and marathon runners (0.4±0.3 pT in group 3 vs. 0.8±0.3 pT in group 1 vs. 1.1±0.5 pT in group 2, p < 0.001). PAF patients had less pseudo-current increase in STAG at peak exercise than healthy volunteers and marathon runners (46% of 26 PAF patients, 81% of 22 healthy subjects vs. 81% of 22 marathon runners, p = 0.002). Sensitivity, specificity, and the area under the receiver-operator characteristics curve of LA pseudo-current increase at peak exercise for differentiating PAF patients from healthy subjects were 77%, 92%, and 0.896. CONCLUSIONS:MCG can provide important non-invasive information for detecting LA dysfunction in PAF patients. Therefore, MCG may help in differentiating PAF patients from healthy subjects.

Keywords: Left atrium, dysfunction, magnetocardiography, paroxysmal atrial fibrillation

DOI: 10.3233/CH-180528

Journal: Clinical Hemorheology and Microcirculation, vol. 72, no. 4, pp. 353-363, 2019