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Comprehensive MRI-guided intracardiac electrophysiological interventions in swine using a combination of active tracking and passive real-time catheter imaging

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Electrophysiological (EP) procedures guided by MRI have the potential of improving catheter navigation and of characterizing both the arrythmogenic substrate as well as ablation induced tissue changes... Here we present the results of a series of navigation, mapping and ablation studies using a combination of active catheter tracking and real-time catheter imaging... The coils were shown as a virtual catheter icon displayed in real-time in the auto-segmented/auto-registered 3D-model, in the pre-acquired MRI planes, and during further scanning... The positions of the catheter tip were confirmed by fully balanced steady-state-free-precession (SSFP) sequence with a frame rate of 8 per second... The intubation of the CS was peformed within a mean time of 11.6 ± 11.3 min. by active tracking only in one pig, in all others by additional passive real-time imaging... Transseptal puncture was successful with a mean procedural time of 16.4 ± 10.1 minutes... In one pig a non-MR-compatible puncture set had to be used... The position of the catheter tip as visualized by active tracking could reliably be confirmed with passive real-time imaging... The combination of active catheter tracking and passive real-time visualization in MR-guided EP-studies using advanced interventional software like the iSuite was safe and enabled efficient navigation, mapping and ablation... A set of standard interventional EP-procedures could be successfully performed... However, there are still limitations before this technique can be considered as an alternative to standard fluoroscopy-guided EP-procedures.

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A: 3D-shell of the advanced navigation platform iSuite (Philips) in anterior-posterior orientation used for active tracking (green catheter tip - white arrow) of the IMRICOR (Vision) ablation catheter. The tip is located in the left atrial appendage (B - white arrow) after successful transseptal puncture. C: Active tracking overlay (green tip - white arrow) on the passively visualized catheter in the IVC and LA.
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Figure 1: A: 3D-shell of the advanced navigation platform iSuite (Philips) in anterior-posterior orientation used for active tracking (green catheter tip - white arrow) of the IMRICOR (Vision) ablation catheter. The tip is located in the left atrial appendage (B - white arrow) after successful transseptal puncture. C: Active tracking overlay (green tip - white arrow) on the passively visualized catheter in the IVC and LA.


Comprehensive MRI-guided intracardiac electrophysiological interventions in swine using a combination of active tracking and passive real-time catheter imaging
A: 3D-shell of the advanced navigation platform iSuite (Philips) in anterior-posterior orientation used for active tracking (green catheter tip - white arrow) of the IMRICOR (Vision) ablation catheter. The tip is located in the left atrial appendage (B - white arrow) after successful transseptal puncture. C: Active tracking overlay (green tip - white arrow) on the passively visualized catheter in the IVC and LA.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4043704&req=5

Figure 1: A: 3D-shell of the advanced navigation platform iSuite (Philips) in anterior-posterior orientation used for active tracking (green catheter tip - white arrow) of the IMRICOR (Vision) ablation catheter. The tip is located in the left atrial appendage (B - white arrow) after successful transseptal puncture. C: Active tracking overlay (green tip - white arrow) on the passively visualized catheter in the IVC and LA.

View Article: PubMed Central - HTML

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Electrophysiological (EP) procedures guided by MRI have the potential of improving catheter navigation and of characterizing both the arrythmogenic substrate as well as ablation induced tissue changes... Here we present the results of a series of navigation, mapping and ablation studies using a combination of active catheter tracking and real-time catheter imaging... The coils were shown as a virtual catheter icon displayed in real-time in the auto-segmented/auto-registered 3D-model, in the pre-acquired MRI planes, and during further scanning... The positions of the catheter tip were confirmed by fully balanced steady-state-free-precession (SSFP) sequence with a frame rate of 8 per second... The intubation of the CS was peformed within a mean time of 11.6 ± 11.3 min. by active tracking only in one pig, in all others by additional passive real-time imaging... Transseptal puncture was successful with a mean procedural time of 16.4 ± 10.1 minutes... In one pig a non-MR-compatible puncture set had to be used... The position of the catheter tip as visualized by active tracking could reliably be confirmed with passive real-time imaging... The combination of active catheter tracking and passive real-time visualization in MR-guided EP-studies using advanced interventional software like the iSuite was safe and enabled efficient navigation, mapping and ablation... A set of standard interventional EP-procedures could be successfully performed... However, there are still limitations before this technique can be considered as an alternative to standard fluoroscopy-guided EP-procedures.

No MeSH data available.


Related in: MedlinePlus