Masaki Sumi

Magnetocardiograms of patients with left ventricular overloading recorded with a second-derivative SQUID gradiometer

Magnetocardiograms (MCGs) were recorded by means of a second-derivative SQUID (superconducting quantum interference device) magnetometer in 60 normal subjects and 95 patients with left ventricular overloading to determine the clinical value of the MCG. In patients with left ventricular overloading, the Q or S wave was increased in the upper anterior part of the thorax, and the R wave was increased in the left lower part of the thorax, indicating increased leftward force due to left ventricular overloading. For detection of left ventricular hypertrophy or dilatation from echocardiographic measurements, the sensitivity and specificity of the MCG were similar to those of the standard ECG, or slightly better. In patients with left ventricular systolic overloading, the Q wave was decreased in the lower anterior part of the thorax, indicating a decreased septal vector. Inversion of the T wave was seen more frequently in the MCGs than in the ECGs of patients with left ventricular overloading, suggesting that the MCG is useful for detecting early abnormalities of repolarization. These results suggest that the MCG may provide information that is difficult to obtain from the standard 12-lead ECG.

Analysis of the T wave of the magnetocardiogram in patients with essential hypertension by means of isomagnetic and vector arrow maps

Magnetocardiograms (MCGs) of 50 normal subjects and 40 patients with essential hypertension were recorded to determine the value of the MCG for detecting abnormal repolarization. Among the patients with essential hypertension, there were nine cases (22.5%) in whom isopotential maps did not show rightward repolarization vectors but isomagnetic and vector arrow maps showed a rightward repolarization vector in some areas in addition to the normal repolarization vector. Departure maps of the ECG showed an increased repolarization vector directed anteriorly in some of these cases. The repolarization abnormality was recognized in only the MCG departure map in four cases, while no case showed abnormality in only the ECG departure map. With the progress of hypertension, the repolarization abnormality was seen more frequently and its detection using the MCG was higher than that using the ECG. Furthermore, multiple dipoles were detected more frequently from the MCG than from the ECG. Thus the MCG seems more useful than the ECG in the analysis of repolarization abnormalities in essential hypertension.

The P wave in the magnetocardiogram

The P wave of the magnetocardiogram (MCG) was investigated in normal subjects and in patients with right and left atrial overloading. In normal subjects, the MCG P wave was positive at right lower sternal sites and negative in the other portions. The current source deduced from the MCG and the isomagnetic map was directed inferiorly and to the left throughout the entire phase of atrial activation. In patients with right atrial overloading, the direction of the current source deduced from the MCG was similar to that of normal subjects, but its amplitude was significantly greater. In left atrial overloadings, a negative-positive biphasic P wave was seen more frequently than in normal subjects at left parasternal sites. In the late phase of atrial activation, the MCG could detect the two dipoles, i.e. one directed inferiorly and other directed to the left. These dipoles might correspond to right and left atrial activities, respectively. These results show that the MCG might add useful information on current source to the conventional electrocardiogram.