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. 2009 Feb 3;24(10):682–688. doi: 10.1002/clc.4960241009

Magnetocardiographic mapping of QRS fragmentation in patients with a history of malignant tachyarrhythmias

P Göudde 1, R Agrawal 1, H‐P Müuller 1, K Czerski 1, P Endt 2, U Steinhoff 2, M Oeff 3, H‐P Schultheiss 3, S Behrens 3,✉
PMCID: PMC6654772  PMID: 11594414

Abstract

Background: The identification of patients at increased risk for ventricular tachycardia or ventricular fibrillation (VT/VF) and sudden cardiac death has consequences for therapeutic options and thus may reduce mortality in patients with coronary artery disease (CAD).

Hypothesis: We hypothesized that the intra‐QRS fragmentation in magnetocardiographic recordings is increased in patients with CAD and with a history of VT/VF.

Methods: Multichannel magnetocardiography (MCG) was carried out in 34 healthy controls, 42 patients with CAD without a history of VT/VF, and 43 patients with CAD and with a history of VT/VF. The intra‐QRS fragmentation was quantified by a new fragmentation score. Its spatial distribution was investigated using two‐dimensional (2‐D) contour maps according to the sensor position of the 49‐channel magnetogradiometer.

Results: Patients with CAD and with a history of VT/VF had significantly increased QRS fragmentation compared with patients with CAD without VT/VF or controls (72.9 ± 37.5,48.5 ± 14.3, and 42.5 ± 7.8, respectively; p< 0.05). The area of high fragmentation in 2‐D contour maps was twice as large in patients with than in those without a history of VT/VF (represented by the number of MCG channels with high fragmentation: 26.3 ± 15.5 vs. 12.4 ± 9.9, p<0.0001). Patients prone to VT/VF could be identified with a sensitivity of 64% and a specificity of 90%.

Conclusion: In patients with CAD and with a history of VT/VF, intra‐QRS fragmentation is increased and the area of high fragmentation in 2‐D contour maps is enlarged. These findings may be helpful in identifying patients with CAD at risk for malignant tachyarrhythmias.

Keywords: magnetocardiography, mapping, ventricular arrhythmias, coronary artery disease, arrhythmogenic substrate

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