1. 1 Magnetocardiogram of a Patient with Heart Disease Copyright © 2005 CardioMag Imaging, Inc. (CMI) 450 Duane Av, Schenectady, NY 12304, USA

2. 2 Patient With 2 VD and prior MI Copyright © 2005 CardioMag Imaging, Inc. (CMI) 450 Duane Av, Schenectady, NY 12304, USA Demographic dataBasic parameters GenderAgeBMIHRBPEF male603561140:8074% Risk factors DMHTPrior MIPrior CADSmokerHLP noyes Other test results ECGECHOTNIIndication normal ACS Coronary Angiography LADLCXRCA stenosislocationstenosislocationstenosislocation 100%prox - mid75%2 nd Ob Marg

3. 3 MCG of the Entire Heartbeat Copyright © 2005 CardioMag Imaging, Inc. (CMI) 450 Duane Av, Schenectady, NY 12304, USA Although the 12 lead ECG in this case is non specific (green ECG trace refers to lead I) the MCG reveals abnormalities even to the untrained eye. Especially during ventricular repolarization the MCG is likely to reflect an acute ischemic event.

4. 4 Depolarization of the Intra- ventricular Septum Copyright © 2005 CardioMag Imaging, Inc. (CMI) 450 Duane Av, Schenectady, NY 12304, USA Septal activity appears to be normal.

5. 5 Ventricular Depolarization Copyright © 2005 CardioMag Imaging, Inc. (CMI) 450 Duane Av, Schenectady, NY 12304, USA The butterfly plot indicates a deviation from the normal case: the traces are widened and show a more complex structure. The vectors describe a loop during ventricular depolarization, which can be associated with a regional loss of conduction velocity. For further information analysis of the static maps is required.

6. 6 Ventricular Depolarization Copyright © 2005 CardioMag Imaging, Inc. (CMI) 450 Duane Av, Schenectady, NY 12304, USA A potential problem spot (circled) is visible in the area of the LV. The first picture refers to early ventricular depolarization and shows the violet pole shaped like an eight. This is a hint for an underlying conduction abnormality – electric currents can’t propagate undisturbed through an area of reduced conduction velocity. This could be either due to a small scar (no abnormal ‘Q waves’ visible) or an (acute) ischemic event. Taking additionally the signature of the ‘ST-T segment’ into account helps clarifying the nature of the disturbance. Early ventricular depolarization Late ventricular depolarization

7. 7 The ‘ST Segment’ Copyright © 2005 CardioMag Imaging, Inc. (CMI) 450 Duane Av, Schenectady, NY 12304, USA The ST segment shows an abnormal spread in the butterfly plot. Interestingly, the magnetic field map distribution doesn’t appear to be random at all as is the case when there is no cardiac electric activity. Here, the maps show an almost constant pattern which merges into ventricular repolarization. It can be concluded that an injury current flows – parts of the left ventricle seem to repolarize early. It is of note that the angle between the two maxima (the magnetic axis) is off by about 60 degrees, which is a strong indicator for an ischemic event.

8. 8 Ventricular Repolarization Copyright © 2005 CardioMag Imaging, Inc. (CMI) 450 Duane Av, Schenectady, NY 12304, USA Ventricular repolarization shows an abnormal field pattern including a turned magnetic axis indicating that the upper part of the left ventricle is not repolarizing. That could be due to a proximally occluded LAD. Since the electric activity is constantly changing its origin it can be concluded that this patient suffers from acute ischemia.

9. 9 Ventricular Repolarization Copyright © 2005 CardioMag Imaging, Inc. (CMI) 450 Duane Av, Schenectady, NY 12304, USA Comparison of de- and repolarization patterns shows that the area of reduced conductivity is present in both. Due to the dynamic changes during repolarization it can be concluded that the problem is acute and needs immediate attention. Note that the 12 lead ECG as well as TNI, and ECHO studies revealed negative results. Late ventricular depolarization Ventricular repolarization