Real-time magnetic resonance-guided ablation of typical right atrial flutter using a combination of active catheter tracking and passive catheter visualization in man: initial results from a consecutive patient series
Open accessAbstract
AIMS: Recently cardiac magnetic resonance (CMR) imaging has been found feasible for the visualization of the underlying substrate for cardiac arrhythmias as well as for the visualization of cardiac catheters for diagnostic and ablation procedures. Real-time CMR-guided cavotricuspid isthmus ablation was performed in a series of six patients using a combination of active catheter tracking and catheter visualization using real-time MR imaging. METHODS AND RESULTS: Cardiac magnetic resonance utilizing a 1.5 T system was performed in patients under deep propofol sedation. A three-dimensional-whole-heart sequence with navigator technique and a fast automated segmentation algorithm was used for online segmentation of all cardiac chambers, which were thereafter displayed on a dedicated image guidance platform. In three out of six patients complete isthmus block could be achieved in the MR scanner, two of these patients did not need any additional fluoroscopy. In the first patient technical issues called for a completion of the procedure in a conventional laboratory, in another two patients the isthmus was partially blocked by magnetic resonance imaging (MRI)-guided ablation. The mean procedural time for the MR procedure was 109 ± 58 min. The intubation of the CS was performed within a mean time of 2.75 ± 2.21 min. Total fluoroscopy time for completion of the isthmus block ranged from 0 to 7.5 min. CONCLUSION: The combination of active catheter tracking and passive real-time visualization in CMR-guided electrophysiologic (EP) studies using advanced interventional hardware and software was safe and enabled efficient navigation, mapping, and ablation. These cases demonstrate significant progress in the development of MR-guided EP procedures.
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Motion in Cardiovascular MR Imaging
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Self-citationFeasibility of real-time magnetic resonance imaging-guided electrophysiology studies in humans
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Self-citationAutomatic Whole Heart Segmentation in Static Magnetic Resonance Image Volumes
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Piorkowski, C., Grothoff, M., Gaspar, T., et al. (2013) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.112.973719 · Cited by 39 · see citing works
Self-citationCatheter Ablation Guided by Real-Time MRI
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Katritsis, D. G., Boriani, G., Cosio, F. G., Hindricks, G., Jaïs, P., Josephson, M. E., Keegan, R., Kim, Y.-H., Knight, B. P., Kuck, K.-H., et al. (2017) · Europace · doi:10.1093/europace/euw301 · Cited by 188 · see citing works
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- Authors
- Hilbert, S., Sommer, P., Gutberlet, M., Gaspar, T., Foldyna, B., Piorkowski, C., Weiss, S., Lloyd, T., Schnackenburg, B., Krueger, S., Fleiter, C., Paetsch, I., Jahnke, C., Hindricks, G., & Grothoff, M.
- Affiliations
- Leipzig Heart Institute (DE)
- Leipzig University (DE)
- Herzzentrum Dresden Universitätsklinik (DE)
- Philips (Germany) (DE)
- Imricor (United States) (US)
- Corresponding author
- Hilbert, Sebastian
- ORCID
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-08-27
- Volume
- 18
- Issue
- 4
- Pages
- 572-577
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2113684919
- Cited by
- 87
- References
- 13
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 11 · 2023: 7 · 2022: 10 · 2021: 6 · 2020: 9 · 2019: 15 · 2018: 9 · 2017: 8 · 2016: 8 · 2015: 1
- FWCI
- 6.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Keywords
- right atrial flutter, cavotricuspid isthmus ablation, real-time MRI, electrophysiologic mapping, fluoroscopy reduction, whole heart segmentation
- MeSH terms
- Adult, Aged, Algorithms, Atrial Flutter, Electrocardiography, Equipment Design, Fluoroscopy, Heart Atria, Cardiac Catheterization, Humans, Hypnotics and Sedatives, Image Interpretation, Computer-Assisted, Male, Middle Aged, Predictive Value of Tests, Time Factors, Propofol, Atrial Function, Right, Treatment Outcome, Catheter Ablation, Electrophysiologic Techniques, Cardiac, Magnetic Resonance Imaging, Interventional, Deep Sedation, Operative Time, Cardiac Catheters
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