Noninvasive mapping reveals recurrent and suddenly changing patterns in atrial fibrillation-a magnetocardiographic...

To study noninvasive magnetocardiographic (MCG) mapping of ongoing atrial fibrillation (AF) and, for the possible mapping patterns observed, to develop simplified but meaningful descriptors or parameters, providing a possible basis for future research and clinical use of the mappings.

MCG mapping with simultaneous ECG was recorded during arrhythmia in patients representing a range of typical, clinically classical atrial arrhythmias. The recordings were assessed using MCG map animations, and a method to compute magnetic field map orientation (MFO) and its time course was created to facilitate presentation of the findings. All the data were segmented into four categories of ECG waveform regularity.

In visual observation of the MCG animations, an abundance of clear spatial and temporal patterns with regularity were found, often perceived as rotations of the map. This rotation and its sudden reversals of direction were distinctly present in the time course of the MFO. The shortest segments with consistent rotation lasted for some hundreds of milliseconds, i.e. a couple of cycles, but segments lasting for tens of seconds were observed as well. In the ECG, all four categories of regularity were present. The rotation of the MFO was observed in all patients under study and regardless of the ECG categories. Further, a change in ECG category during a measurement was frequently, but not always, found to be simultaneous with a change in the rotation pattern of the MFO. Utilization of spatial information of MCG mapping could enable detection of both regularities and instantaneous phenomena during AF.

Cardiac mapping may offer a useful noninvasive means to study the mechanisms of AF, including superior temporal resolution.