Delphine Elbes1,2, Julie Magat1, Assaf Govari3, Yaron Ephrath3, Delphine Vieillot4, Christopher Beeckler3, Rukshen Weerasooriya5, Pierre Jais1,6, Bruno Quesson1. 1. IHU LIRYC/CRCTB, INSERM U1045, University of Bordeaux, Bordeaux, France. 2. Biomedical Ultrasonics, Biotherapy & Biopharmaceuticals Laboratory (BUBBL), Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Old Road Campus Research Building, Headington, Oxford OX3 7DQ, UK. 3. Biosense Webster, Diamond Bar, USA. 4. Plateforme Technologique d'Innovation Biomedical, Universite de Bordeaux, Pessac, France. 5. University of Western Australia, Perth, Western Australia. 6. Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
Abstract
AIMS: Interventional cardiac catheter mapping is routinely guided by X-ray fluoroscopy, although radiation exposure remains a significant concern. Feasibility of catheter ablation for common flutter has recently been demonstrated under magnetic resonance imaging (MRI) guidance. The benefit of catheter ablation under MRI could be significant for complex arrhythmias such as atrial fibrillation (AF), but MRI-compatible multi-electrode catheters such as Lasso have not yet been developed. This study aimed at demonstrating the feasibility and safety of using a multi-electrode catheter [magnetic resonance (MR)-compatible Lasso] during MRI for cardiac mapping. We also aimed at measuring the level of interference between MR and electrophysiological (EP) systems. METHODS AND RESULTS: Experiments were performed in vivo in sheep (N = 5) using a multi-electrode, circular, steerable, MR-compatible diagnostic catheter. The most common MRI sequences (1.5T) relevant for cardiac examination were run with the catheter positioned in the right atrium. High-quality electrograms were recorded while imaging with a maximal signal-to-noise ratio (peak-to-peak signal amplitude/peak-to-peak noise amplitude) ranging from 5.8 to 165. Importantly, MRI image quality was unchanged. Artefacts induced by MRI sequences during mapping were demonstrated to be compatible with clinical use. Phantom data demonstrated that this 10-pole circular catheter can be used safely with a maximum of 4°C increase in temperature. CONCLUSIONS: This new MR-compatible 10-pole catheter appears to be safe and effective. Combining MR and multipolar EP in a single session offers the possibility to correlate substrate information (scar, fibrosis) and EP mapping as well as online monitoring of lesion formation and electrical endpoint. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Interventional cardiac catheter mapping is routinely guided by X-ray fluoroscopy, although radiation exposure remains a significant concern. Feasibility of catheter ablation for common flutter has recently been demonstrated under magnetic resonance imaging (MRI) guidance. The benefit of catheter ablation under MRI could be significant for complex arrhythmias such as atrial fibrillation (AF), but MRI-compatible multi-electrode catheters such as Lasso have not yet been developed. This study aimed at demonstrating the feasibility and safety of using a multi-electrode catheter [magnetic resonance (MR)-compatible Lasso] during MRI for cardiac mapping. We also aimed at measuring the level of interference between MR and electrophysiological (EP) systems. METHODS AND RESULTS: Experiments were performed in vivo in sheep (N = 5) using a multi-electrode, circular, steerable, MR-compatible diagnostic catheter. The most common MRI sequences (1.5T) relevant for cardiac examination were run with the catheter positioned in the right atrium. High-quality electrograms were recorded while imaging with a maximal signal-to-noise ratio (peak-to-peak signal amplitude/peak-to-peak noise amplitude) ranging from 5.8 to 165. Importantly, MRI image quality was unchanged. Artefacts induced by MRI sequences during mapping were demonstrated to be compatible with clinical use. Phantom data demonstrated that this 10-pole circular catheter can be used safely with a maximum of 4°C increase in temperature. CONCLUSIONS: This new MR-compatible 10-pole catheter appears to be safe and effective. Combining MR and multipolar EP in a single session offers the possibility to correlate substrate information (scar, fibrosis) and EP mapping as well as online monitoring of lesion formation and electrical endpoint. Published on behalf of the European Society of Cardiology. All rights reserved.
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 Journal: Eur Radiol Date: 2016-08-23 Impact factor: 5.315
Authors: Rahul K Mukherjee; Sébastien Roujol; Henry Chubb; James Harrison; Steven Williams; John Whitaker; Louisa O'Neill; John Silberbauer; Radhouene Neji; Rainer Schneider; Thomas Pohl; Tom Lloyd; Mark O'Neill; Reza Razavi Journal: Europace Date: 2018-09-01 Impact factor: 5.214
Authors: Rahul K Mukherjee; Caroline Mendonca Costa; Radhouene Neji; James L Harrison; Iain Sim; Steven E Williams; John Whitaker; Henry Chubb; Louisa O'Neill; Rainer Schneider; Tom Lloyd; Thomas Pohl; Sébastien Roujol; Steven A Niederer; Reza Razavi; Mark D O'Neill Journal: Europace Date: 2019-09-01 Impact factor: 5.214