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


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.


CONCLUSIONS
Completely non-fluoroscopic ablation guided by RTMRI using a steerable and non-ferromagnetic catheter is a promising novel technology in interventional electrophysiology.
Hoffmann
Boris A
BA
Department of Cardiology/Electrophysiology, University Hospital Eppendorf, University Heart Center, Martinistr 52, D-20246 Hamburg, Germany. b.hoffmann@uke.de
Koops
Andreas
A
Rostock
Thomas
T
Müllerleile
Kai
K
Steven
Daniel
D
Karst
Roman
R
Steinke
Mark U
MU
Drewitz
Imke
I
Lund
Gunnar
G
Koops
Susan
S
Adam
Gerhard
G
Willems
Stephan
S
D000818:Animals; D001282:Atrial Flutter / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004594:Electrophysiology; D005240:Feasibility Studies; D018810:Magnetic Resonance Angiography; D053783:Magnetic Resonance Imaging, Interventional; D013552:Swine; D014261:Tricuspid Valve / Q000601:surgery*