Cardiovascular Magnetic Resonance Guided Electrophysiology Studies

Catheter ablation is a first line treatment for many cardiac arrhythmias and is generally performed under x-ray fluoroscopy guidance. However, current techniques for ablating complex arrhythmias such as atrial fibrillation and ventricular tachycardia are associated with suboptimal success rates and prolonged radiation exposure. Pre-procedure 3D CMR has improved understanding of the anatomic basis of complex arrhythmias and is being used for planning and guidance of ablation procedures. A particular strength of CMR compared to other imaging modalities is the ability to visualize ablation lesions. Post-procedure CMR is now being applied to assess ablation lesion location and permanence with the goal of indentifying factors leading to procedure success and failure. In the future, intra-procedure real-time CMR, together with the ability to image complex 3-D arrhythmogenic anatomy and target additional ablation to regions of incomplete lesion formation, may allow for more successful treatment of even complex arrhythmias without exposure to ionizing radiation. Development of clinical grade CMR compatible electrophysiology devices is required to transition intra-procedure CMR from pre-clinical studies to more routine use in patients.

PMID: 19580654

Jacobo Kirsch

Associate Center Director, Imaging Institute
Cardiopulmonary Imaging, Section Head
Cleveland Clinic Florida
Weston, FL
Posted in Magnetic Resonance Imaging and tagged , , , , .

One Comment

  1. Kolandaivelu, et al. presents a very thorough review of the state of MRI in the field of electrophysiology. They discuss the most recent advances in MR technology and review some of the feasibility studies done to date. Topics discussed include intra-operative monitoring techniques, faster 2-D and 3-D imaging, device visualization, among others.

    This article is available for free: Open Access.

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