Magnetic resonance imaging-guided conventional catheter ablation of isthmus-dependent atrial flutter using active catheter imaging.
Ablation
Atrial flutter
Cavotricuspid isthmus
Electrophysiology
Interventional cardiac magnetic resonance
Journal
Heart rhythm O2
ISSN: 2666-5018
Titre abrégé: Heart Rhythm O2
Pays: United States
ID NLM: 101768511
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
entrez:
7
11
2022
pubmed:
8
11
2022
medline:
8
11
2022
Statut:
epublish
Résumé
Interventional cardiac magnetic resonance (iCMR) has been established as a radiation-free alternative compared to standard fluoroscopy-guided catheter ablation for cavotricuspid isthmus (CTI)-dependent atrial flutter to image anatomy, structural alterations, and further catheter guidance. The purpose of this study was to explore the safety, feasibility, and efficacy of CTI ablations performed completely in the iCMR suite using active catheter imaging. Consecutive patients underwent iCMR-guided catheter ablation for CTI-dependent atrial flutter. Procedures were performed in a 1.5-T magnetic resonance (MR) imaging unit with MR-conditional ablation catheters. Catheter guidance was achieved using active catheter imaging via integrated MR receive tip coils. Acute success, periprocedural complications, and short-term follow-up were collected for further analysis. All patients (N = 15; 73% male; median age 70 years; interquartile range [67-82]) achieved acute procedural success without any complication. Median procedural time was 43 minutes [33-58] with median radiofrequency delivery time of 18 minutes [12-26]. Postprocedural lesion visualization scanning was completed in a median of 32 minutes [10-42]. None of the patients with 6-month follow-up had atrial flutter recurrence. In the iCMR suite, CTI-dependent atrial flutter ablation could be achieved safely using active catheter imaging without any complication. It further allows detailed anatomic visualization of the CTI, intraprocedural lesion visualization, and exclusion of pericardial effusion.
Sections du résumé
Background
UNASSIGNED
Interventional cardiac magnetic resonance (iCMR) has been established as a radiation-free alternative compared to standard fluoroscopy-guided catheter ablation for cavotricuspid isthmus (CTI)-dependent atrial flutter to image anatomy, structural alterations, and further catheter guidance.
Objective
UNASSIGNED
The purpose of this study was to explore the safety, feasibility, and efficacy of CTI ablations performed completely in the iCMR suite using active catheter imaging.
Methods
UNASSIGNED
Consecutive patients underwent iCMR-guided catheter ablation for CTI-dependent atrial flutter. Procedures were performed in a 1.5-T magnetic resonance (MR) imaging unit with MR-conditional ablation catheters. Catheter guidance was achieved using active catheter imaging via integrated MR receive tip coils. Acute success, periprocedural complications, and short-term follow-up were collected for further analysis.
Results
UNASSIGNED
All patients (N = 15; 73% male; median age 70 years; interquartile range [67-82]) achieved acute procedural success without any complication. Median procedural time was 43 minutes [33-58] with median radiofrequency delivery time of 18 minutes [12-26]. Postprocedural lesion visualization scanning was completed in a median of 32 minutes [10-42]. None of the patients with 6-month follow-up had atrial flutter recurrence.
Conclusion
UNASSIGNED
In the iCMR suite, CTI-dependent atrial flutter ablation could be achieved safely using active catheter imaging without any complication. It further allows detailed anatomic visualization of the CTI, intraprocedural lesion visualization, and exclusion of pericardial effusion.
Identifiants
pubmed: 36340492
doi: 10.1016/j.hroo.2022.06.011
pii: S2666-5018(22)00155-6
pmc: PMC9626877
doi:
Types de publication
Journal Article
Langues
eng
Pagination
553-559Informations de copyright
© 2022 Heart Rhythm Society. Published by Elsevier Inc.
Références
Europace. 2013 Jan;15(1):101-8
pubmed: 22849974
Circulation. 2016 Apr 5;133(14):e506-74
pubmed: 26399663
Heart Rhythm. 2019 Nov;16(11):1611-1618
pubmed: 31150815
Europace. 2016 Apr;18(4):572-7
pubmed: 26316146
Circ Arrhythm Electrophysiol. 2013 Feb;6(1):e7-10
pubmed: 23424226
Magn Reson Imaging Clin N Am. 2015 Nov;23(4):579-89
pubmed: 26499276
Heart Rhythm O2. 2021 Apr 03;2(3):262-270
pubmed: 34337577
Eur Heart J Cardiovasc Imaging. 2019 Feb 1;20(2):147-156
pubmed: 30307544
Circulation. 2000 May 9;101(18):2178-84
pubmed: 10801759
Magn Reson Med. 2020 Apr;83(4):1368-1379
pubmed: 31565818
Eur Heart J Cardiovasc Imaging. 2018 Jan 1;19(1):84-91
pubmed: 28180237
Eur Heart J. 2020 Feb 1;41(5):655-720
pubmed: 31504425
Circulation. 2004 Aug 31;110(9):1030-5
pubmed: 15326078
Eur Heart J. 2006 Aug;27(15):1833-40
pubmed: 16807277
JACC Clin Electrophysiol. 2017 Feb;3(2):89-103
pubmed: 29759398