Feasibility of Real-Time Magnetic Resonance Imaging for Catheter Guidance in Electrophysiology Studies

Compared with fluoroscopy, the current imaging standard of care for guidance of electrophysiology procedures, magnetic resonance imaging (MRI) provides improved soft-tissue resolution and eliminates radiation exposure. However, because of inherent magnetic forces and electromagnetic interference, th...

Full description

Saved in:
Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2008-07, Vol.118 (3), p.223-229
Main Authors: NAZARIAN, Saman, KOLANDAIVELU, Aravindan, BERGER, Ronald D, BLUEMKE, David A, LARDO, Albert C, HALPERIN, Henry R, ZVIMAN, Menekhem M, MEININGER, Glenn R, KATO, Ritsushi, SUSIL, Robert C, ROGUIN, Ariel, DICKFELD, Timm L, ASHIKAGA, Hiroshi, CALKINS, Hugh
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Blood and lymphatic vessels
Bundle of His
Cardiac Catheterization - adverse effects
Cardiac Catheterization - instrumentation
Cardiac Catheterization - methods
Cardiac Pacing, Artificial
Cardiology. Vascular system
Cardiovascular system
Catheterization
Computer Systems
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Dogs
Echo-Planar Imaging
Electrophysiology - methods
Feasibility Studies
Heart Atria
Hot Temperature
Humans
Magnetic Resonance Imaging, Interventional - adverse effects
Medical sciences
Pharmacology. Drug treatments
Vasodilator agents. Cerebral vasodilators
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Compared with fluoroscopy, the current imaging standard of care for guidance of electrophysiology procedures, magnetic resonance imaging (MRI) provides improved soft-tissue resolution and eliminates radiation exposure. However, because of inherent magnetic forces and electromagnetic interference, the MRI environment poses challenges for electrophysiology procedures. In this study, we sought to test the feasibility of performing electrophysiology studies with real-time MRI guidance. An MRI-compatible electrophysiology system was developed. Catheters were targeted to the right atrium, His bundle, and right ventricle of 10 mongrel dogs (23 to 32 kg) via a 1.5-T MRI system using rapidly acquired fast gradient-echo images (approximately 5 frames per second). Catheters were successfully positioned at the right atrial, His bundle, and right ventricular target sites of all animals. Comprehensive electrophysiology studies with recording of intracardiac electrograms and atrial and ventricular pacing were performed. Postprocedural pathological evaluation revealed no evidence of thermal injury to the myocardium. After proof of safety in animal studies, limited real-time MRI-guided catheter mapping studies were performed in 2 patients. Adequate target catheter localization was confirmed via recording of intracardiac electrograms in both patients. To the best of our knowledge, this is the first study to report the feasibility of real-time MRI-guided electrophysiology procedures. This technique may eliminate patient and staff radiation exposure and improve real-time soft tissue resolution for procedural guidance.
ISSN:0009-7322
1524-4539
DOI:10.1161/circulationaha.107.742452