Fenici Riccardo, Picerni Marco, Fenici Peter, Brisinda Donatella
Biomagnetism and Clinical Physiology International Center, Rome, Italy.
Catholic University of the Sacred Heart, School of Medicine and Surgery.
Am Heart J Plus. 2025 Feb 23;52:100514. doi: 10.1016/j.ahjo.2025.100514. eCollection 2025 Apr.
Decades of experimental and clinical studies, along with the most recent clinical trials, have demonstrated the diagnostic potential of magnetocardiography, particularly for the non-invasive early diagnosis of myocardial ischemia. It has also proven to be a valuable clinical tool for monitoring fetal well-being, normal growth, prenatal arrhythmias, and risk markers for sudden death. Such applications have recently received official recognition from Health Canada and the American Heart Association. This unquestionable success, and the additional evidence of magnetocardiography's high sensitivity in diagnosing infiltrative and inflammatory cardiomyopathies, has sparked renewed interest among clinicians. However, while these aforementioned applications are likely to significantly influence the broader clinical adoption of magnetocardiography, the general focus on these areas has shifted attention away from what we have always regarded as the fundamental strength of contactless cardiac magnetic field mapping: its unique ability to bridge the gap between experimental electrophysiology at the cellular level and non-invasive clinical assessments of human electrophysiology. This review aims to engage readers by sharing our vision, experience, and several key research milestones, emphasizing the lesser-explored yet significant potential of magnetocardiography. Specifically, it highlights its unique capability to detect electrically silent phenomena that may be critical for the timely and accurate identification of arrhythmogenic focal electrotonic and vortex currents, which can trigger or sustain life-threatening arrhythmias.
数十年来的实验和临床研究，以及最近的临床试验，都证明了心磁图的诊断潜力，特别是在心肌缺血的无创早期诊断方面。它也已被证明是监测胎儿健康、正常生长、产前心律失常以及猝死风险标志物的一种有价值的临床工具。此类应用最近已获得加拿大卫生部和美国心脏协会的官方认可。这种无可争议的成功，以及心磁图在诊断浸润性和炎性心肌病方面具有高灵敏度的更多证据，引发了临床医生新的兴趣。然而，虽然上述应用可能会显著影响心磁图在更广泛临床中的应用，但对这些领域的普遍关注转移了人们对我们一直视为非接触式心脏磁场映射基本优势的关注：它独特的能力，即弥合细胞水平的实验电生理学与人类电生理学的无创临床评估之间的差距。本综述旨在通过分享我们的愿景、经验和几个关键研究里程碑来吸引读者，强调心磁图尚未得到充分探索但意义重大的潜力。具体而言，它突出了其独特的能力，即能够检测电沉默现象，这些现象对于及时准确地识别可能引发或维持危及生命的心律失常的致心律失常局灶性电紧张电流和漩涡电流至关重要。
