Real-time magnetic resonance imagingguided radiofrequency atrial ablation and visualization of lesion formation at 3 Tesla

Gaston R. Vergara, Sathya Vijayakumar, Eugene G. Kholmovski, Joshua J E Blauer, Mike A. Guttman, Christopher Gloschat, Gene Payne, Kamal Vij, Nazem W. Akoum, Marcos Daccarett, Christopher J. McGann, Rob S. MacLeod, Nassir F. Marrouche

Research output: Contribution to journalArticle

Abstract

Background Magnetic resonance imaging (MRI) allows visualization of location and extent of radiofrequency (RF) ablation lesion, myocardial scar formation, and real-time (RT) assessment of lesion formation. In this study, we report a novel 3-Tesla RT -RI based porcine RF ablation model and visualization of lesion formation in the atrium during RF energy delivery. Objective The purpose of this study was to develop a 3-Tesla RT MRI-based catheter ablation and lesion visualization system. Methods RF energy was delivered to six pigs under RT MRI guidance. A novel MRI-compatible mapping and ablation catheter was used. Under RT MRI, this catheter was safely guided and positioned within either the left or right atrium. Unipolar and bipolar electrograms were recorded. The catheter tiptissue interface was visualized with a T1-weighted gradient echo sequence. RF energy was then delivered in a power-controlled fashion. Myocardial changes and lesion formation were visualized with a T2-weighted (T2W) half Fourier acquisition with single-shot turbo spin echo (HASTE) sequence during ablation. Results RT visualization of lesion formation was achieved in 30% of the ablations performed. In the other cases, either the lesion was formed outside the imaged region (25%) or the lesion was not created (45%) presumably due to poor tissuecatheter tip contact. The presence of lesions was confirmed by late gadolinium enhancement MRI and macroscopic tissue examination. Conclusion MRI-compatible catheters can be navigated and RF energy safely delivered under 3-Tesla RT MRI guidance. Recording electrograms during RT imaging also is feasible. RT visualization of lesion as it forms during RF energy delivery is possible and was demonstrated using T2W HASTE imaging.

Original languageEnglish (US)
Pages (from-to)295-303
Number of pages9
JournalHeart Rhythm
Volume8
Issue number2
DOIs
StatePublished - Feb 2011
Externally publishedYes

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Magnetic Resonance Spectroscopy
Magnetic Resonance Imaging
Catheter Ablation
Catheters
Heart Atria
Swine
Gadolinium
Cicatrix

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Lesion visualization
  • Radiofrequency energy
  • Real-time magnetic resonance imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Vergara, G. R., Vijayakumar, S., Kholmovski, E. G., Blauer, J. J. E., Guttman, M. A., Gloschat, C., ... Marrouche, N. F. (2011). Real-time magnetic resonance imagingguided radiofrequency atrial ablation and visualization of lesion formation at 3 Tesla. Heart Rhythm, 8(2), 295-303. https://doi.org/10.1016/j.hrthm.2010.10.032

Real-time magnetic resonance imagingguided radiofrequency atrial ablation and visualization of lesion formation at 3 Tesla. / Vergara, Gaston R.; Vijayakumar, Sathya; Kholmovski, Eugene G.; Blauer, Joshua J E; Guttman, Mike A.; Gloschat, Christopher; Payne, Gene; Vij, Kamal; Akoum, Nazem W.; Daccarett, Marcos; McGann, Christopher J.; MacLeod, Rob S.; Marrouche, Nassir F.

In: Heart Rhythm, Vol. 8, No. 2, 02.2011, p. 295-303.

Research output: Contribution to journalArticle

Vergara, GR, Vijayakumar, S, Kholmovski, EG, Blauer, JJE, Guttman, MA, Gloschat, C, Payne, G, Vij, K, Akoum, NW, Daccarett, M, McGann, CJ, MacLeod, RS & Marrouche, NF 2011, 'Real-time magnetic resonance imagingguided radiofrequency atrial ablation and visualization of lesion formation at 3 Tesla', Heart Rhythm, vol. 8, no. 2, pp. 295-303. https://doi.org/10.1016/j.hrthm.2010.10.032
Vergara, Gaston R. ; Vijayakumar, Sathya ; Kholmovski, Eugene G. ; Blauer, Joshua J E ; Guttman, Mike A. ; Gloschat, Christopher ; Payne, Gene ; Vij, Kamal ; Akoum, Nazem W. ; Daccarett, Marcos ; McGann, Christopher J. ; MacLeod, Rob S. ; Marrouche, Nassir F. / Real-time magnetic resonance imagingguided radiofrequency atrial ablation and visualization of lesion formation at 3 Tesla. In: Heart Rhythm. 2011 ; Vol. 8, No. 2. pp. 295-303.
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title = "Real-time magnetic resonance imagingguided radiofrequency atrial ablation and visualization of lesion formation at 3 Tesla",
abstract = "Background Magnetic resonance imaging (MRI) allows visualization of location and extent of radiofrequency (RF) ablation lesion, myocardial scar formation, and real-time (RT) assessment of lesion formation. In this study, we report a novel 3-Tesla RT -RI based porcine RF ablation model and visualization of lesion formation in the atrium during RF energy delivery. Objective The purpose of this study was to develop a 3-Tesla RT MRI-based catheter ablation and lesion visualization system. Methods RF energy was delivered to six pigs under RT MRI guidance. A novel MRI-compatible mapping and ablation catheter was used. Under RT MRI, this catheter was safely guided and positioned within either the left or right atrium. Unipolar and bipolar electrograms were recorded. The catheter tiptissue interface was visualized with a T1-weighted gradient echo sequence. RF energy was then delivered in a power-controlled fashion. Myocardial changes and lesion formation were visualized with a T2-weighted (T2W) half Fourier acquisition with single-shot turbo spin echo (HASTE) sequence during ablation. Results RT visualization of lesion formation was achieved in 30{\%} of the ablations performed. In the other cases, either the lesion was formed outside the imaged region (25{\%}) or the lesion was not created (45{\%}) presumably due to poor tissuecatheter tip contact. The presence of lesions was confirmed by late gadolinium enhancement MRI and macroscopic tissue examination. Conclusion MRI-compatible catheters can be navigated and RF energy safely delivered under 3-Tesla RT MRI guidance. Recording electrograms during RT imaging also is feasible. RT visualization of lesion as it forms during RF energy delivery is possible and was demonstrated using T2W HASTE imaging.",
keywords = "Atrial fibrillation, Catheter ablation, Lesion visualization, Radiofrequency energy, Real-time magnetic resonance imaging",
author = "Vergara, {Gaston R.} and Sathya Vijayakumar and Kholmovski, {Eugene G.} and Blauer, {Joshua J E} and Guttman, {Mike A.} and Christopher Gloschat and Gene Payne and Kamal Vij and Akoum, {Nazem W.} and Marcos Daccarett and McGann, {Christopher J.} and MacLeod, {Rob S.} and Marrouche, {Nassir F.}",
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T1 - Real-time magnetic resonance imagingguided radiofrequency atrial ablation and visualization of lesion formation at 3 Tesla

AU - Vergara, Gaston R.

AU - Vijayakumar, Sathya

AU - Kholmovski, Eugene G.

AU - Blauer, Joshua J E

AU - Guttman, Mike A.

AU - Gloschat, Christopher

AU - Payne, Gene

AU - Vij, Kamal

AU - Akoum, Nazem W.

AU - Daccarett, Marcos

AU - McGann, Christopher J.

AU - MacLeod, Rob S.

AU - Marrouche, Nassir F.

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N2 - Background Magnetic resonance imaging (MRI) allows visualization of location and extent of radiofrequency (RF) ablation lesion, myocardial scar formation, and real-time (RT) assessment of lesion formation. In this study, we report a novel 3-Tesla RT -RI based porcine RF ablation model and visualization of lesion formation in the atrium during RF energy delivery. Objective The purpose of this study was to develop a 3-Tesla RT MRI-based catheter ablation and lesion visualization system. Methods RF energy was delivered to six pigs under RT MRI guidance. A novel MRI-compatible mapping and ablation catheter was used. Under RT MRI, this catheter was safely guided and positioned within either the left or right atrium. Unipolar and bipolar electrograms were recorded. The catheter tiptissue interface was visualized with a T1-weighted gradient echo sequence. RF energy was then delivered in a power-controlled fashion. Myocardial changes and lesion formation were visualized with a T2-weighted (T2W) half Fourier acquisition with single-shot turbo spin echo (HASTE) sequence during ablation. Results RT visualization of lesion formation was achieved in 30% of the ablations performed. In the other cases, either the lesion was formed outside the imaged region (25%) or the lesion was not created (45%) presumably due to poor tissuecatheter tip contact. The presence of lesions was confirmed by late gadolinium enhancement MRI and macroscopic tissue examination. Conclusion MRI-compatible catheters can be navigated and RF energy safely delivered under 3-Tesla RT MRI guidance. Recording electrograms during RT imaging also is feasible. RT visualization of lesion as it forms during RF energy delivery is possible and was demonstrated using T2W HASTE imaging.

AB - Background Magnetic resonance imaging (MRI) allows visualization of location and extent of radiofrequency (RF) ablation lesion, myocardial scar formation, and real-time (RT) assessment of lesion formation. In this study, we report a novel 3-Tesla RT -RI based porcine RF ablation model and visualization of lesion formation in the atrium during RF energy delivery. Objective The purpose of this study was to develop a 3-Tesla RT MRI-based catheter ablation and lesion visualization system. Methods RF energy was delivered to six pigs under RT MRI guidance. A novel MRI-compatible mapping and ablation catheter was used. Under RT MRI, this catheter was safely guided and positioned within either the left or right atrium. Unipolar and bipolar electrograms were recorded. The catheter tiptissue interface was visualized with a T1-weighted gradient echo sequence. RF energy was then delivered in a power-controlled fashion. Myocardial changes and lesion formation were visualized with a T2-weighted (T2W) half Fourier acquisition with single-shot turbo spin echo (HASTE) sequence during ablation. Results RT visualization of lesion formation was achieved in 30% of the ablations performed. In the other cases, either the lesion was formed outside the imaged region (25%) or the lesion was not created (45%) presumably due to poor tissuecatheter tip contact. The presence of lesions was confirmed by late gadolinium enhancement MRI and macroscopic tissue examination. Conclusion MRI-compatible catheters can be navigated and RF energy safely delivered under 3-Tesla RT MRI guidance. Recording electrograms during RT imaging also is feasible. RT visualization of lesion as it forms during RF energy delivery is possible and was demonstrated using T2W HASTE imaging.

KW - Atrial fibrillation

KW - Catheter ablation

KW - Lesion visualization

KW - Radiofrequency energy

KW - Real-time magnetic resonance imaging

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