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Interactive real-time mapping and catheter ablation of the cavotricuspid isthmus guided by magnetic resonance imaging in a porcine model.

Hoffmann BA, Koops A, Rostock T, Müllerleile K, Steven D, Karst R, Steinke MU, Drewitz I, Lund G, Koops S, Adam G, Willems S - Eur. Heart J. (2009)

Bottom Line: Catheter position and movement during manipulation were continuously visualized during the entire intervention.Two porcine prematurely died due to VT/VF.In 15 of 18 procedures (83.3%) a complete CTI block was proven by conventional mapping in the electrophysiological (EP) lab.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology/Electrophysiology, University Hospital Eppendorf, University Heart Center, Martinistr 52, D-20246 Hamburg, Germany. b.hoffmann@uke.de

ABSTRACT

Aims: We investigated the feasibility of real-time magnetic resonance imaging (RTMRI) guided ablation of the cavotricuspid isthmus (CTI) by using a MRI-compatible ablation catheter.

Methods and results: Cavotricuspid isthmus ablation was performed in an interventional RTMRI suite by using a novel 7 French, steerable, non-ferromagnetic ablation catheter in a porcine in vivo model (n = 20). The catheter was introduced and navigated by RTMRI visualization only. Catheter position and movement during manipulation were continuously visualized during the entire intervention. Two porcine prematurely died due to VT/VF. Anatomical completion of the CTI ablation line could be achieved after a mean of 6.3+/-3 RF pulses (RF energy: 1807+/-1016.4 Ws/RF pulse, temperature: 55.9+/-5.9 degrees C) in n = 18 animals. In 15 of 18 procedures (83.3%) a complete CTI block was proven by conventional mapping in the electrophysiological (EP) lab.

Conclusion: Completely non-fluoroscopic ablation guided by RTMRI using a steerable and non-ferromagnetic catheter is a promising novel technology in interventional electrophysiology.

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Interventional magnetic resonance imaging suite with 1.5 T scanner and in-room monitor console (1).
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EHP460F2: Interventional magnetic resonance imaging suite with 1.5 T scanner and in-room monitor console (1).

Mentions: The RTMRI-guided CTI ablation was performed in a clinical interventional MRI suite (1.5 T, Symphony™, Siemens Medical Solutions, Erlangen, Germany) (Figure 2). The images were displayed on an in-room monitor console (IMC, Siemens) for continuous imaging control of the movement and positioning of the catheter. Eight-channel phased-array body surface coils were used and ECG electrodes were connected for ECG gating during MR tomography.


Interactive real-time mapping and catheter ablation of the cavotricuspid isthmus guided by magnetic resonance imaging in a porcine model.

Hoffmann BA, Koops A, Rostock T, Müllerleile K, Steven D, Karst R, Steinke MU, Drewitz I, Lund G, Koops S, Adam G, Willems S - Eur. Heart J. (2009)

Interventional magnetic resonance imaging suite with 1.5 T scanner and in-room monitor console (1).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2821629&req=5

EHP460F2: Interventional magnetic resonance imaging suite with 1.5 T scanner and in-room monitor console (1).
Mentions: The RTMRI-guided CTI ablation was performed in a clinical interventional MRI suite (1.5 T, Symphony™, Siemens Medical Solutions, Erlangen, Germany) (Figure 2). The images were displayed on an in-room monitor console (IMC, Siemens) for continuous imaging control of the movement and positioning of the catheter. Eight-channel phased-array body surface coils were used and ECG electrodes were connected for ECG gating during MR tomography.

Bottom Line: Catheter position and movement during manipulation were continuously visualized during the entire intervention.Two porcine prematurely died due to VT/VF.In 15 of 18 procedures (83.3%) a complete CTI block was proven by conventional mapping in the electrophysiological (EP) lab.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology/Electrophysiology, University Hospital Eppendorf, University Heart Center, Martinistr 52, D-20246 Hamburg, Germany. b.hoffmann@uke.de

ABSTRACT

Aims: We investigated the feasibility of real-time magnetic resonance imaging (RTMRI) guided ablation of the cavotricuspid isthmus (CTI) by using a MRI-compatible ablation catheter.

Methods and results: Cavotricuspid isthmus ablation was performed in an interventional RTMRI suite by using a novel 7 French, steerable, non-ferromagnetic ablation catheter in a porcine in vivo model (n = 20). The catheter was introduced and navigated by RTMRI visualization only. Catheter position and movement during manipulation were continuously visualized during the entire intervention. Two porcine prematurely died due to VT/VF. Anatomical completion of the CTI ablation line could be achieved after a mean of 6.3+/-3 RF pulses (RF energy: 1807+/-1016.4 Ws/RF pulse, temperature: 55.9+/-5.9 degrees C) in n = 18 animals. In 15 of 18 procedures (83.3%) a complete CTI block was proven by conventional mapping in the electrophysiological (EP) lab.

Conclusion: Completely non-fluoroscopic ablation guided by RTMRI using a steerable and non-ferromagnetic catheter is a promising novel technology in interventional electrophysiology.

Show MeSH