[Present state and future of magnetocardiographic localization]

The magnetic fields caused by the human heart's electrical excitation can be recorded without contact over the body surface to obtain the "magnetocardiogram" (MCG). As compared to the conventional electrocardiogram (ECG), the magnetic fields are influenced far less by the conductive properties of the body tissues, so that the MCG permits a more direct and accurate analysis of cardiac electrical excitation. Most important, the MCG allows an exact localization of the underlying electrical activity, based on the recorded magnetic field distribution. For localization, the MCG does not rely on pattern recognition algorithms such as the ECG, instead, a computational 3-D localization is performed using simplified source and volume conductor models. The spatial accuracy of this method, in combination with magnetic resonance imaging for anatomical assignment of the localization results, has been determined to be 10 to 15 mm for sources close to the body surface and 15 to 20 mm for sources in the posterior parts of the heart.Clinically, the magnetocardiogram can be applied for the non-invasive localization of accessory pathways in Wolff-Parkinson-White syndrome, and of ventricular ectopies (PVC and VT). Especially in combination with a subsequent interventional treatment by catheter ablation, the method may improve the clinical management of these conditions.While the registration techniques are standardized in a way that permits routine clinical application, the data evaluation has to be optimized and simplified before this method can be completely handed over for physicians to use.