Learning objectives
The course is based on a multidisciplinary approach (physical, electrophysiological, technological and clinical) aimed at giving the student a broad understanding of the scientific basis of Biomagnetism and of the rational for its application in the clinical field.
It is aimed at training, also practically, a new type of professional with interdisciplinary skills, able to interact with different professional figures, both in research and clinical fields, therefore with significant prospects of post-graduate employment given the current increase in industrial investments for the development and introduction of these novel non-invasive technologies into clinical practice.
The course will more extensively focus on training the student in Biomagnetism applications in cardiology, in particular on MCG mapping as a rapid and non-invasive screening method with high negative predictive value for the targeted diagnostics and the "risk assessment" of patients with ischemic heart disease, cardiomyopathies and/or cardiac arrhythmias.
For each topic real clinical cases will be presented, in the form of a "problem to be solved", using the information and methods learned (see methods).
Prerequisites
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Course unit content
The course is designed to train students in the discipline of Biomagnetism and its main clinical applications, with particular attention to the recording and processing techniques of cardiac and cerebral biomagnetic signals.
The course will then focus on the modalities for translating Magnetocardiography (MCG) into a clinical environment and integrating biomagnetic information with the current standardized methods of experimental and clinical electro-cardiological study, to obtain innovative diagnostic information that is exclusive and / or complementary to those inferred from electrocardiographic recordings (ECG), from surface (BSPM) and / or intracardiac potential mapping.
Among these, of particular interest is the greater accuracy of biomagnetic recordings in localizing three-dimensionally the site of origin of normal and pathological electrophysiological events, useful for the development of innovative and simplified non-invasive electroanatomical imaging systems of arrhythmogenic substrates susceptible to ablative treatment and pre-interventional identification of patients in whom such treatment can be truly effective.
Full programme
Cellular electrogenesis, electric field and magnetic field.
Intensity of the magnetic field generated by the heart, the brain, peripheral nerves, striated muscle, gastro-enteric system
Technology and methods of traditional and recently developed signal recording: (cryogenic systems / SQUID, non-cryogenic / magneto-optical sensors)
Signal / Noise Ratio in magnetic recordings
Methods of reduction / subtraction of environmental electro-magnetic noise (shielded cabin, gradiometric systems)
Magnetocardiography (MCG) and Magnetoencephalography (MEG).
Signal processing methods
Clinical applications of MCG and MEG
Notions of "practical and rapid" reading of the ECG
Concept of "Heart Rate Variability" and methods of study
Integrated multimodal electroanatomical imaging concept (3D EAI).
Clinical applications of 3D EAI in cardiology
Stress MCG
Fetal Magnetocardiography (FMCG)
Clinical applications of 3D EAI in neurology
MCG of the experimental animal.
Bibliography
Educational material uploaded to Elly
Malmivuo J & Plonsey R. Bioelectromagnetism http://www.bem.fi/book/
Fenici R, Brisinda D, Sorbo AR, Venuti A. MCG Instrumentation and Applications. In: Rogalla H, Kes PH. Superconductivity Centennial Book 2011 Taylor and Francis Group. Chapter 10.3:24-44
Biomagnetism, Applications and Theory. Ed. by H. Weinberg, G. Stroink, T. Katila - Pergamon Press pp. 106-114, N.Y, 1985
J Nenonen, R Iimoniemi and T. Katila Proceedings of the 12th International Conference on Biomagnetism: ISBN 951-22-5402-6, 530-533, 2001. http://biomag2000.hut.fi/papers_all.html
Teaching methods
Both the lectures and the practical training will be carried out in an interactive way, according to the "Problem-based learning", a teaching method centered on the student. Each problem presented is "authentic" and similar to a problem that students could actually face in the real-world professional duty.
There must be several possible solutions and different ways of arriving at these solutions.
Students should not already be able to solve it, but are encouraged to define the problem, describe the initial knowledge already in their possession, identify the new knowledge to be learned to solve the problem, establish the next steps to be taken.
During the lectures the basic concepts of electromagnetism will be discussed. The technological evolution in the field of instrumental development for the measurement of the magnetic field produced by the electrogenic activity of various tissues and organs. Methods of reduction/ subtraction of environmental noise to make biomagnetic measurements possible in clinical environments and to make the MCG based non-invasive electroanatomical imaging based clinically available in the outpatient setting and at the patient's bedside.
The course will be complemented by a cycle of laboratory exercises aimed at learning the methods of recording and processing the MCG.
The exercises can be performed at the BACPIC (with the MCG system operating in an unshielded outpatient hospital environment), at the Catholic University of the Sacred Heart in Rome and at the Electrophysiology Laboratory of the University of Parma.
Assessment methods and criteria
Oral exam on the topics covered in class, including practical test of interpretation of ECG and MCG patterns of major interest in the clinical field.
Other information
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