Thirty years of clinical magnetocardiography at the Catholic University of Rome: Diagnostic value and new perspectives for the treatment of cardiac arrhythmias

after more than 10 years of single–channel MCG and several preliminary tests with seven- and nine-channel prototypes, the first (and still unique) unshielded instrumentation for multichannel (36-channel) MCG was installed, in 2002, in the Rome Biomagnetism Center, fully equipped to combine non-invasive MCG–based cardiac mapping with standardized stress testing and with multimodal EAI during interventional cardiac electrophysiology. Since then, the 36-channel MCG was fully efficient and routinely employed in our unshielded hospital facility for the clinical evaluation of ambulatory patients and to assess and validate the diagnostic utility of contactless MCG, with special focus on its application for non-invasive pre-interventional multimodal imaging and localization of arrhythmogenic substrates, as well as for the triage of chest pain patients, early detection of acute cardiac ischemia and the study of stable CAD. Moreover, the unique capability of such instrumentation to operate in an unshielded catheterization laboratory for invasive electrophysiologic procedures provided a unique opportunity to compare directly MCG and catheter assessment of electrophysiological parameters and to use such information to validate the diagnostic accuracy of MCG as a unique “one-shop-stop” method for contactless pre-interventional and intraoperative 3D imaging method of arrhythmogenic substrates. Indeed, our intuition that MCG could be used to guide aimed electrophysiology, myocardial biopsy and ablation of cardiac arrhythmias was originally patented already at the end of the eighties, thus well in advance of the first “magnetic” technology for invasive 3D EAI and navigation of ablation catheters, which is nowadays widely accepted as an essential support for interventional electrophysiology.