title: Magnetic resonance imaging guided transatrial electrophysiological studies in swine using active catheter tracking - experience with 14 cases.
abstract: OBJECTIVE
  To evaluate the feasibility of performing comprehensive Cardiac Magnetic resonance (CMR) guided electrophysiological (EP) interventions in a porcine model encompassing left atrial access.
  
  
  METHODS
  After introduction of two femoral sheaths 14 swine (41 ± 3.6 kg) were transferred to a 1.5 T MR scanner. A three-dimensional whole-heart sequence was acquired followed by segmentation and the visualization of all heart chambers using an image-guidance platform. Two MR conditional catheters were inserted. The interventional protocol consisted of intubation of the coronary sinus, activation mapping, transseptal left atrial access (n = 4), generation of ablation lesions and eventually ablation of the atrioventricular (AV) node. For visualization of the catheter tip active tracking was used. Catheter positions were confirmed by passive real-time imaging.
  
  
  RESULTS
  Total procedure time was 169 ± 51 minutes. The protocol could be completed in 12 swine. Two swine died from AV-ablation induced ventricular fibrillation. Catheters could be visualized and navigated under active tracking almost exclusively. The position of the catheter tips as visualized by active tracking could reliably be confirmed with passive catheter imaging.
  
  
  CONCLUSIONS
  Comprehensive CMR-guided EP interventions including left atrial access are feasible in swine using active catheter tracking.
  
  
  CONCLUSIONS
  • Comprehensive CMR-guided electrophysiological interventions including LA access were conducted in swine. • Active catheter-tracking allows efficient catheter navigation also in a transseptal approach. • More MR-conditional tools are needed to facilitate left atrial interventions in humans.
authors.affiliation: Department of Radiology, University of Leipzig - Heart Center, Struempellstr.39, 04289, Leipzig, Germany. grothoff@gmx.de.
authors.forename: Matthias
authors.identifier: http://orcid.org/0000-0003-2014-4821
authors.initials: M
authors.lastname: Grothoff
authors.affiliation: Department of Radiology, University of Leipzig - Heart Center, Struempellstr.39, 04289, Leipzig, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Gutberlet
authors.affiliation: Department of Electrophysiology, University of Leipzig - Heart Center, Struempellstr.39, 04289, Leipzig, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hindricks
authors.affiliation: Helios Klinikum Berlin-Buch, Department of Orthopaedic Surgery, Schwanebecker Chaussee 50, 13125, Berlin, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Fleiter
authors.affiliation: Philips Healthcare, Philipsstr. 14, 20099, Hamburg, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schnackenburg
authors.affiliation: Philips Innovative Technologies, Roentgenstr. 24-26, 22335, Hamburg, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Weiss
authors.affiliation: Philips Innovative Technologies, Roentgenstr. 24-26, 22335, Hamburg, Germany.
authors.forename: Sascha
authors.initials: S
authors.lastname: Krueger
authors.affiliation: Department of Electrophysiology, University of Dresden - Heart Center, Fetscherstr. 76, 01307, Dresden, Germany.
authors.forename: Christopher
authors.initials: C
authors.lastname: Piorkowski
authors.affiliation: Department of Electrophysiology, University of Dresden - Heart Center, Fetscherstr. 76, 01307, Dresden, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gaspar
authors.affiliation: Imricor Medical Systems, 400 Gateway Blvd., Burnsville, MN, 55337, USA.
authors.forename: Steve
authors.initials: S
authors.lastname: Wedan
authors.affiliation: Imricor Medical Systems, 400 Gateway Blvd., Burnsville, MN, 55337, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lloyd
authors.affiliation: Department of Electrophysiology, University of Leipzig - Heart Center, Struempellstr.39, 04289, Leipzig, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Sommer
authors.affiliation: Department of Electrophysiology, University of Leipzig - Heart Center, Struempellstr.39, 04289, Leipzig, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Hilbert
mesh_terms: D000818:Animals; D057785:Catheters; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods*; D006325:Heart Atria; D008279:Magnetic Resonance Imaging / Q000379:methods; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D013552:Swine
keywords: Animal experiments; Atrial fibrillation; Cardiac electrophysiology; Catheter ablation, radiofrequency; Magnetic resonance imaging, interventional