Circ Cardiovasc Imaging

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Circ Cardiovasc Imaging Cardiovascular Magnetic Resonance–Guided Electrophysiological Interventions by Ingo Paetsch, Cosima Jahnke, Sebastian Hilbert, Sascha Krueger, Steffen Weiss, Jouke Smink, Bernhard Schnackenburg, Tom Lloyd, Gerhard Hindricks, and Philipp Sommer Circ Cardiovasc Imaging Volume 10(1):e005780 December 27, 2016 Copyright © American Heart Association, Inc. All rights reserved.

Set-up of cardiovascular magnetic resonance–guided electrophysiological (CMR-EP) ablation procedure. Set-up of cardiovascular magnetic resonance–guided electrophysiological (CMR-EP) ablation procedure. Upper, In-room set-up of CMR scanner environment with MR-compatible display monitors showing side by side the CMR-EP interventional framework (left-sided monitor, 3-dimensional CMR surface mesh model in combination with real-time cine images for passive catheter visualization or active catheter tracking; right-sided monitor, intracardiac electrograms). For active tracking, the MR-compatible catheters were connected to the scanner via an interface located at the table end, and the interventionalist requested active tracking or real-time cine imaging via a footpedal. Note the optoacoustic headsets ensuring constant communication of the interventionalist with the CMR operator(s) in the console room. Lower, Set-up of CMR scanner console room together with EP impulse generator system for electrophysiological stimulation maneuvers. Ingo Paetsch et al. Circ Cardiovasc Imaging. 2017;10:e005780 Copyright © American Heart Association, Inc. All rights reserved.

Cardiovascular magnetic resonance–guided electrophysiological (CMR-EP) interventional framework (patient no. 2, Movie II in the Data Supplement). Cardiovascular magnetic resonance–guided electrophysiological (CMR-EP) interventional framework (patient no. 2, Movie II in the Data Supplement). Side-by-side display of 3-dimensional (3D) surface rendered model showing right atrium (green) with superior/inferior vena cava (light blue) and still images of cine real-time CMR acquisitions and multiplanar slice reconstructions of 3D whole-heart data set. Note the clear visibility and demarcation of the cavotricuspid isthmus against the tricuspid valve plane/right ventricle. Ablation catheter tip, red/yellow; ablation points, red; and reference catheter tip, green/yellow. Ingo Paetsch et al. Circ Cardiovasc Imaging. 2017;10:e005780 Copyright © American Heart Association, Inc. All rights reserved.

Activation map after successful cardiovascular magnetic resonance (CMR)–guided atrial flutter ablation (patient no. 2). Activation map after successful cardiovascular magnetic resonance (CMR)–guided atrial flutter ablation (patient no. 2). Activation times demonstrated isthmus conduction delay of 112 ms equivalent to complete block (defined as >100 ms). Ablation catheter tip, red/yellow; ablation points, red; and reference catheter tip, green/yellow. Ingo Paetsch et al. Circ Cardiovasc Imaging. 2017;10:e005780 Copyright © American Heart Association, Inc. All rights reserved.

Comparison of preablation and postablation T2-weighted black blood cardiovascular magnetic resonance (CMR) imaging of cavotricuspid isthmus (patient no. 2). Comparison of preablation and postablation T2-weighted black blood cardiovascular magnetic resonance (CMR) imaging of cavotricuspid isthmus (patient no. 2). Acute radiofrequency (RF)-induced ablation lesions clearly demarcated as high signal intensity, focal edema (white arrows) <10 min after RF pulse termination. Ingo Paetsch et al. Circ Cardiovasc Imaging. 2017;10:e005780 Copyright © American Heart Association, Inc. All rights reserved.