MRI-based catheter ablation : Current status and outlook

Fluoroscopy-based catheter ablation has established itself as a standard procedure for the treatment of patients with cardiac arrhythmias. However, it is subject to certain limitations with regard to the visualization of arrhythmogenic substrate and ablation lesions and is associated with radiation...

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Published inHerzschrittmachertherapie & Elektrophysiologie Vol. 33; no. 1; p. 19
Main Authors Khalaph, M, Guckel, D, Bergau, L, Sohns, C, Jahnke, C, Paetsch, I, Sommer, P
Format Journal Article
LanguageGerman
Published Germany 01.03.2022
Subjects
Arrhythmias, Cardiac - etiology
Arrhythmias, Cardiac - surgery
Catheter Ablation - methods
Fluoroscopy
Heart Diseases
Humans
Magnetic Resonance Imaging
Arrhythmia substrate
Magnetic resonance imaging
Electrophysiology
Cardiac arrhythmias
Ablation
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Summary:Fluoroscopy-based catheter ablation has established itself as a standard procedure for the treatment of patients with cardiac arrhythmias. However, it is subject to certain limitations with regard to the visualization of arrhythmogenic substrate and ablation lesions and is associated with radiation exposure. Within the framework of studies, initial experience with MRI-based, radiation-free electrophysiological examinations and ablations could be gained. The integration of MRI technology into electrophysiological procedures promises numerous advantages. The ability to operate in a radiation-free environment during MRI-based catheter ablation is significant and promising. Furthermore, MRI provides important procedure-relevant information in terms of visualization of individual arrhythmogenic substrate. In order to further improve immediate and long-term ablation success, especially in the context of complex arrhythmias and structural heart disease, the direct and successful integration of MRI-generated findings into the ablation process is of utmost importance. The future of MRI-based catheter ablation could thus lie in particular in the treatment of more complex cardiac arrhythmias, which require personalized therapy paths. In this respect, however, the data situation is still extremely limited. Further technical developments and larger studies are indispensable in order to gain further important insights into the feasibility, safety and success rate of MRI-based invasive electrophysiological diagnostics and therapy in comparison to conventional ablation methods.
ISSN:1435-1544