Cardiovascular Magnetic Resonance–Guided Electrophysiological Interventions
Radiofrequency Ablation of Typical Atrial Flutter
Cardiovascular magnetic resonance–guided electrophysiological ablation of typical atrial flutter was performed in 5 patients using a fully magnetic resonance-compatible mapping and ablation catheter (Vision-MR; Imricor) on a 1.5-Tesla cardiovascular magnetic resonance system (Ingenia; Philips; Figure 1). All patients were under continuous physiological monitoring (including surface vector and intracardiac electrograms, pulse oximetry, and invasive blood pressure measurements) during intravenous propofol sedation. For interventional guidance, a 3-dimensional (3D), navigator-gated whole-heart sequence (steady-state–free precession) was acquired, and a 3D surface mesh model of all cardiac cavities was reconstructed with a fully automatic segmentation algorithm (Figure 2). Active catheter tracking and real-time passive catheter visualization were displayed simultaneously on in-room and scanner console monitors; optoacoustic headsets allowed for constant communication (Figure 1). Total procedure duration was <60 minutes with <1 minute for coronary sinus intubation (reference catheter for activation mapping, Movie I in the Data Supplement). Four out of 5 patients had complete isthmus block (defined as >100 ms isthmus conduction delay) after cardiovascular magnetic resonance–guided electrophysiological ablation (Figures 3 and 4; Movie II in the Data Supplement).
Drs Krueger, Weiss, Smink, and Schnackenburg are all employees of Philips Healthcare. Dr Lloyd is an employee of Imricor Medical Systems. The other authors report no conflicts.
The Data Supplement is available at http://circimaging.ahajournals.org/lookup/suppl/doi:10.1161/CIRCIMAGING.116.005780/-/DC1.
- © 2016 American Heart Association, Inc.