Novel Non-Invasive Index for Prediction of Responders in Cardiac Resynchronization Therapy Using High-Resolution Magnetocardiography

Takahiro Nakashima, Shunsuke Usami, Takeshi Aiba, Shogo Oishi, Yoshitaka Kimura, Shoji Kawakami, Yuko Yamada-Inoue, Soshiro Ogata, Nobuhiko Ueda, Kenzaburo Nakajima, Tsukasa Kamakura, Mitsuru Wada, Kenichiro Yamagata, Kohei Ishibashi, Koji Miyamoto, Takashi Noda, Satoshi Nagase, Hideaki Kanzaki, Chisato Izumi, Satoshi YasudaShiro Kamakura, Hiroshi Takaki, Masaru Sugimachi, Kengo Kusano

Research output: Contribution to journalArticlepeer-review


Background: Approximately one-third of patients with advanced heart failure (HF) do not respond to cardiac resynchronization therapy (CRT). We investigated whether the left ventricular (LV) conduction pattern on magnetocardiography (MCG) can predict CRT responders. Methods and Results: This retrospective study enrolled 56 patients with advanced HF (mean [±SD] LV ejection fraction [LVEF] 23±8%; QRS duration 145±19ms) and MCG recorded before CRT. MCG-QRS current arrow maps were classified as multidirectional (MDC; n=28) or unidirectional (UDC; n=28) conduction based on a change of either ≥35° or <35°, respectively, in the direction of the maximal current arrow after the QRS peak. Baseline New York Heart Association functional class and LVEF were comparable between the 2 groups, but QRS duration was longer and the presence of complete left bundle branch block and LV dyssynchrony was higher in the UDC than MDC group. Six months after CRT, 30 patients were defined as responders, with significantly more in the UDC than MDC group (89% vs. 14%, respectively; P<0.001). Over a 5-year follow-up, Kaplan-Meyer analysis showed that adverse cardiac events (death or implantation of an LV assist device) were less frequently observed in the UDC than MDC group (6/28 vs. 15/28, respectively; P=0.027). Multivariate analysis revealed that UDC on MCG was the most significant predictor of CRT response (odds ratio 69.8; 95% confidence interval 13.14–669.32; P<0.001). Conclusions: Preoperative non-invasive MCG may predict the CRT response and long-term outcome after CRT.

Original languageEnglish
Pages (from-to)216-2174
Number of pages1959
JournalCirculation Journal
Issue number12
Publication statusPublished - 2020


  • Cardiac resynchronization therapy
  • Electrocardiogram
  • Heart failure
  • Magnetocardiography
  • Prognosis


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