CLINICAL INDICATIONS OF INTEREST

Where MCG Stands Today

We may have started with myocardial ischemia, but MCG was never intended to be a single-purpose diagnostic.

Clinical Indications

Have questions? Contact Us.

Pre- and Post-Operative Cardiac Screening

Magnetocardiography (MCG) could be used as a preoperative screening tool for moderate and high-risk patients to evaluate the potential cardiac risks associated with surgery. It could provide physicians with valuable insights into the function of the myocardium, aiding in risk stratification, and enabling better planning and patient outcomes. Additionally, MCG could be used for postoperative assessments, allowing clinicians to detect and monitor electrical and functional changes of the myocardium that may have occurred as a result of surgery. MCG could prove to be a valuable tool for providing rapid, non-invasive, and radiation-free cardiac evaluations both before and after surgery.

Heart Rhythm and Arrythmia

Magnetocardiography (MCG) can be a valuable tool for detecting and diagnosing a range of cardiac arrhythmias (Kwong et al., 2013), including atrial (Her et al., 2019) and ventricular fibrillation. MCG could potentially help clinicians evaluate the effectiveness of ablation treatments, localize arrhythmia, and provide insights into a patient's risk of adverse events, such as sudden cardiac death. It could be an important diagnostic tool for healthcare professionals to use when assessing arrhythmia and is a potential key factor in providing optimal care for these patients.

Fetal Cardiology and Congenital Heart Disease

Magnetocardiography (MCG) is a non-invasive modality that has been used to detect congenital conditions in the fetus (Sturm et al., 2004) (Strasburger et al., 2008), such as long QT syndrome (Bolin et al., 2019), and could potentially be used to monitor functional cardiac changes in pediatric and adult populations with post-operative congenital heart disease. With MCG, clinicians have the opportunity to gain more insight into the condition of patients with congenital diseases, potentially allowing them to make more informed decisions regarding treatment and ultimately improving quality of care.

Public Health

Magnetocardiography (MCG) could be a valuable tool for public health screening and research in populations that are traditionally under-served, including women's cardiology, rural populations, and African-American, Latin-American, Asian, American Indian, Alaska Native, and Pacific Islander peoples. In addition, MCG has potential applications in clinical settings, such as assessing the risk of adverse events associated with hypertension1, examining cardiovascular changes associated with aging2, and determining the microvascular and cardiovascular impacts of e-cigarette use.

Exercise Physiology and Sports Cardiology

Magnetocardiography (MCG) has the ability to detect subtle electrophysiological changes in the myocardium that may occur during sports training. This makes MCG a potentially ideal tool for fast, non-invasive assessment in sports cardiology, performance coaching programs, and collegiate and professional team sports. It could offer a tool for evaluating the cardio-pulmonary effectiveness of new training programs and assess the readiness of individual athletes for competition. MCG could also be used to evaluate the effectiveness of exercise interventions in at-risk patient populations.

Cardiac Regenerative Medicine and Therapeutics

Magnetocardiography (MCG) is a non-invasive, radiation-free imaging modality that could show the capability to assess improvement in coronary flow reserve, myocardial contractility, and other cardiac effects of cell-based cardiac regenerative therapies. In addition, MCG could be utilized to evaluate the efficacy of these treatments over time, allowing clinicians to gain a more comprehensive understanding of the effectiveness of such therapies during and subsequent to treatment.

Post Acute Coronavirus Syndrome

Magnetocardiography (MCG) is a potentially invaluable tool for studying and monitoring the long-term cardiac effects of COVID-19. MCG could provide insight into electrophysiological changes, making it a potentially ideal modality for detecting endocarditis and microvascular damage in the heart that may not be visible with other imaging techniques. This could be beneficial for accurately diagnosing and monitoring cardiac conditions both during and after COVID-19 and other viral infection in a clinical and research setting.

Cardiomyopathy

Magnetocardiography (MCG) has the potential to be a valuable diagnostic tool for clinicians when managing cardiomyopathy (Schmitz et al., 1989), including dilated, hypertrophic, and restrictive forms. MCG could provide physicians with the ability to make detailed assessments of cardiac function (Kawakami et al., 2017) that could be used to inform decisions on the best available treatments, including assessment of pharmaceuticals, surgical interventions, and pre-device implantation.

Therapeutic Drug Monitoring and Efficacy

Magnetocardiography (MCG) could offer a completely non-invasive, rapid, and non-ionizing method for evaluating cardiac effects during clinical trials of cardiac and non-cardiac medications. It could be a useful tool for assessing the efficacy of cardiac drugs in clinical settings, especially in individuals with hyperlipidemia, those undergoing statin therapy, and type II diabetics. With the help of MCG, pharmaceutical researchers could objectively evaluate the cardiac efficacy and effects of in-pipeline pharmacologics, obtaining rapid and accurate data for better patient outcomes.

Metabolic Syndrome & Diabetes

Magnetocardiography (MCG) has been used to aid in determining cardiac risk in patients with diabetes or metabolic syndrome (Chang et al., 2015), thereby helping clinicians more accurately determine which patients would benefit from more aggressive treatments and which may not require further interventions. Additionally, MCG could be used to monitor and evaluate the effectiveness of treatment regimens for diabetes and metabolic syndrome, such as medication, dietary modifications, and weight loss.

Revascularization Follow-Up

Normalization of magnetocardiography (MCG) scans has been observed within hours to days of a successful percutaneous coronary intervention (PCI) procedure in comparison to pre-PCI MCG scans (On et al., 2007). MCG is highly sensitive to myocardial changes, making it a potentially ideal tool to evaluate the success of a PCI procedure, diagnose the cause of refractory angina, and detect stent restenosis (Hailer et al., 2005) in patients who have undergone revascularization. Given MCG’s low burden to patients, clinicians could potentially leverage rapid MCG testing to assess the success of PCI procedures and evaluate the presence of any post-procedure myocardial changes.

Heart Transplantation

Magnetocardiography (MCG) has potential to detect early cardiac transplant rejection, during the difficult-to-diagnose initial post-transplant month. Improving the detection rates of rejection events could help reduce long-term complications associated with this condition. In addition, MCG technology could be employed as a long-term monitoring tool to identify and track the progression of cardiac allograft vasculopathy (CAV) in patients who have received a cardiac transplant (Wu et al., 2013).

Cardio-Oncology

Magnetocardiography (MCG) is a method of non-invasive cardiac monitoring which could provide valuable insights for oncologists and cardiologists when evaluating the potential cardiotoxic effects of chemotherapy and left-sided radiation on the heart. MCG could be used as an alternative to more burdensome techniques such as positron emission tomography (PET) and stress testing, offering a safer and more cost-effective way to assess and anticipate long-term cardiac changes that may arise after the completion of oncological treatment.

Heart Failure

Magnetocardiography (MCG) is a rapid, non-invasive modality that has been used to assess potential candidates for cardiac resynchronization therapy (CRT) prior to pacemaker implantation (Nakashima et al., 2013). MCG is able to detect subtle changes in cardiac electrophysiology, which could provide valuable insight for diagnosing and monitoring heart failure patients with preserved or reduced ejection fraction. By leveraging the unique capabilities of MCG, clinicians could improve treatment and outcomes for these individuals.

Coronary Microvascular Disease

The MICRO study (NCT05150054) aims to evaluate the effectiveness of magnetocardiography (MCG) in diagnosing coronary microvascular disease (Quesada et al., 2022). The primary goal is to compare the coronary flow reserve (CFR) values obtained through MCG to those obtained through invasive angiography. MCG could also be used to assess changes in CFR pre- and post-treatment, measure the index of microvascular resistance (IMR) and diagnose microvascular vasospastic angina. The MICRO study is especially important to clinicians, as MCG has the potential to provide a rapid, non-invasive, and radiation-free diagnostic test for coronary microvascular disease, which is often under-diagnosed, particularly in women.

Acute Coronary Syndrome in an ER Setting

In an emergency room setting, clinicians often need to rapidly rule out myocardial ischemia, especially Type II MI. Magnetocardiography (MCG) could play a role in diagnosing difficult-to-diagnose acute coronary syndrome (ACS) cases, especially in angina patients who have a known history of CAD and patients without significant ECG changes (Kwon et al., 2010). Additionally, MCG could be compared to traditional stress testing methods for diagnosing NSTEMI in an emergency room patient population.

Coronary Artery Disease & Flow Limiting Stenosis

Magnetocardiography (MCG) is a non-invasive tool that can measure functional changes in the myocardium, making it an attractive option for determining the functional significance of stenoses as measured by fractional flow reserve (FFR) (Park et al., 2015) or instantaneous free-wave ratio (iFR). Additionally, MCG could be used to measure myocardial perfusion and assess myocardial viability, potentially offering a rapid and non-ionizing alternative to positron emission tomography (PET) imaging (Coriasso et al., 2021).

Bolin, E. H., Escalona‐Vargas, D., Daily, J. A., Siegel, E. R., Lowery, C. L., Coker, J., Stowe, Z. N., & Eswaran, H. (2019). Magnetocardiographic identification of prolonged fetal corrected QT interval in women receiving treatment for opioid use disorder. Journal of Obstetrics and Gynaecology Research, 45(10), 1989–1996. https://doi.org/10.1111/jog.14055

Brisinda, D., Caristo, M. E., & Fenici, R. (2006). Contactless magnetocardiographic mapping in anesthetized wistar rats: Evidence of age-related changes of cardiac electrical activity. American Journal of Physiology-Heart and Circulatory Physiology, 291(1). https://doi.org/10.1152/ajpheart.01048.2005

Chang, Y.-C., Wu, C.-C., Lin, C.-H., Wu, Y.-W., Yang, Y.-C., Chang, T.-J., Jiang, Y.-D., & Chuang, L.-M. (2015). Early myocardial repolarization heterogeneity is detected by magnetocardiography in diabetic patients with cardiovascular risk factors. PLOS ONE, 10(7). https://doi.org/10.1371/journal.pone.0133192Coriasso, N., Takla, R. B., Rodriguez, D., Pearson, C., Pena, M., & Daher, E. (2021). Abstract 10642: A novel way to predict obstructive coronary artery disease requiring revascularization: The use of magnetocardiography. Circulation, 144(Suppl_1). https://doi.org/10.1161/circ.144.suppl_1.10642

Hailer, B., Van Leeuwen, P., Chaikovsky, I., Auth-Eisernitz, S., Schafer, H., & Gronemeyer, D. (2005). The value of magnetocardiography in the course of coronary intervention. Annals of Noninvasive Electrocardiology, 10(2), 188–196. https://doi.org/10.1111/j.1542-474x.2005.05625.x

Hailer, B., Van Leeuwen, P., Lange, S., Chaikovsky, I., & Grönemeyer, D. (2007). Magnetocardiography in hypertensive and coronary artery disease. International Congress Series, 1300, 488–491. https://doi.org/10.1016/j.ics.2007.01.019

Her, A.-Y., Shin, E.-S., Zhou, Q., Wierzbinski, J., Vidal-Lopez, S., Saleh, A., Kim, Y. H., Garg, S., Jung, F., & Brachmann, J. (2019). Magnetocardiography detects left atrial dysfunction in paroxysmal atrial fibrillation. Clinical Hemorheology and Microcirculation, 72(4), 353–363. https://doi.org/10.3233/ch-180528

Kawakami, S., Takaki, H., Hashimoto, S., Kimura, Y., Nakashima, T., Aiba, T., Kusano, K. F., Kamakura, S., Yasuda, S., & Sugimachi, M. (2017). Utility of high-resolution magnetocardiography to predict later cardiac events in nonischemic cardiomyopathy patients with normal QRS duration. Circulation Journal, 81(1), 44–51. https://doi.org/10.1253/circj.cj-16-0683 Kwon, H., Kim, K., Lee, Y.-H., Kim, J.-M., Yu, K. K., Chung, N., & Ko, Y.-G. (2010). Non-invasive magnetocardiography for the early diagnosis of coronary artery disease in patients presenting with acute chest pain. Circulation Journal, 74(7), 1424–1430. https://doi.org/10.1253/circj.cj-09-0975

Kwong, J. S. W., Leithäuser, B., Park, J.-W., & Yu, C.-M. (2013). Diagnostic value of magnetocardiography in coronary artery disease and cardiac arrhythmias: A review of clinical data. International Journal of Cardiology, 167(5), 1835–1842. https://doi.org/10.1016/j.ijcard.2012.12.056

Nakashima, T., Takaki, H., Usami, S., Yamada, Y., Okamura, H., Aiba, T., Yasuda, S., Kamakura, S., Shimizu, W., & Sugimachi, M. (2013). Multi-directional ventricular conduction on magnetocardiography predicts poor prognosis after CRT implantation. European Heart Journal, 34(suppl 1), 1917–1917. https://doi.org/10.1093/eurheartj/eht308.1917

On, K., Watanabe, S., Yamada, S., Takeyasu, N., Nakagawa, Y., Nishina, H., Morimoto, T., Aihara, H., Kimura, T., Sato, Y., Tsukada, K., Kandori, A., Miyashita, T., Ogata, K., Suzuki, D., Yamaguchi, I., & Aonuma, K. (2007). Integral value of JT interval in magnetocardiography is sensitive to coronary stenosis and improves soon after coronary revascularization. Circulation Journal, 71(10), 1586–1592. https://doi.org/10.1253/circj.71.1586

Park, J.-W., Shin, E.-S., Ann, S. H., Gödde, M., Park, L. S.-I., Brachmann, J., Vidal-Lopez, S., Wierzbinski, J., Lam, Y.-Y., & Jung, F. (2015). Validation of magnetocardiography versus fractional flow reserve for detection of coronary artery disease. Clinical Hemorheology and Microcirculation, 59(3), 267–281. https://doi.org/10.3233/ch-141912

Quesada, O., Pico, M., Palmer, C., Yildiz, M., Miranda, R., Malhotra, R., Setegn, E., Legreaux, S., Moore, B., Philip, R., Shrivastava, P., Takla, R., & Henry, T. (2022). Magnetocardiography as a noninvasive diagnostic strategy for suspected coronary microvascular dysfunction. European Heart Journal, 43(Supplement_2). https://doi.org/10.1093/eurheartj/ehac544.1188 Schmitz, L., Brockmeier, K., Trahms, L., & Erné, S. N. (1989). Magnetocardiography in patients with cardiomyopathy and operated congenital heart disease. Advances in Biomagnetism, 453–456. https://doi.org/10.1007/978-1-4613-0581-1_97 Strasburger, J. F., Cheulkar, B., & Wakai, R. T. (2008). Magnetocardiography for fetal arrhythmias. Heart Rhythm, 5(7), 1073–1076. https://doi.org/10.1016/j.hrthm.2008.02.035

Sturm, R., Müller, H.-P., Pasquarelli, A., Demelis, M., Erné, S. N., Terinde, R., & Lang, D. (2004). Multi-channel magnetocardiography for detecting beat morphology variations in fetal arrhythmias. Prenatal Diagnosis, 24(1), 1–9. https://doi.org/10.1002/pd.764 Wu, Y.-W., Lee, C.-M., Liu, Y.-B., Wang, S.-S., Huang, H.-C., Tseng, W.-K., Jui, H.-Y., Wang, S.-Y., Horng, H.-E., Yang, H.-C., & Wu, C.-C. (2013). Usefulness of magnetocardiography to detect coronary artery disease and cardiac allograft vasculopathy. Circulation Journal, 77(7), 1783–1790. https://doi.org/10.1253/circj.cj-12-1170