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European Heart Journal Advance Access published online on November 5, 2009
European Heart Journal, doi:10.1093/eurheartj/ehp460
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that the original authorship is properly and fully attributed; the Journal, Learned Society and Oxford University Press are attributed as the original place of publication with correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org.

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

Boris A. Hoffmann1,*,{dagger}, Andreas Koops2,{dagger}, Thomas Rostock1, Kai Müllerleile1, Daniel Steven1, Roman Karst1, Mark U. Steinke2, Imke Drewitz1, Gunnar Lund2, Susan Koops3, Gerhard Adam2 and Stephan Willems1

1 Department of Cardiology/Electrophysiology, University Hospital Eppendorf, University Heart Center, Martinistr. 52, D-20246 Hamburg, Germany
2 Department of Radiology, University Hospital Eppendorf, Hamburg, Germany
3 Department of Pathology, University Hospital Eppendorf, Hamburg, Germany

Received 21 August 2009; revised 23 September 2009; accepted 4 October 2009 * Corresponding author. Tel: +49 40 7410 54120, Fax: +49 40 7410 55993, Email: b.hoffmann{at}uke.de

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°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.

Key Words: Interventional magnetic resonance imaging • Atrial flutter • Catheter ablation • Non-ferromagnetic ablation catheter • Interactive real time

{dagger} The first two authors contributed equally to the study.


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