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European Radiology
Published in: European Radiology 5/2017

01-05-2017 | Cardiac

Magnetic resonance imaging guided transatrial electrophysiological studies in swine using active catheter tracking – experience with 14 cases

Authors: Matthias Grothoff, Matthias Gutberlet, Gerhard Hindricks, Christian Fleiter, Bernhard Schnackenburg, Steffen Weiss, Sascha Krueger, Christopher Piorkowski, Thomas Gaspar, Steve Wedan, Thomas Lloyd, Philipp Sommer, Sebastian Hilbert

Published in: European Radiology | Issue 5/2017

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Abstract

Objectives

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.

Key points

• 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.
Appendix
Available only for authorised users
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Metadata
Title
Magnetic resonance imaging guided transatrial electrophysiological studies in swine using active catheter tracking – experience with 14 cases
Authors
Matthias Grothoff
Matthias Gutberlet
Gerhard Hindricks
Christian Fleiter
Bernhard Schnackenburg
Steffen Weiss
Sascha Krueger
Christopher Piorkowski
Thomas Gaspar
Steve Wedan
Thomas Lloyd
Philipp Sommer
Sebastian Hilbert
Publication date
01-05-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 5/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4560-7

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