Radiofrequency ablation guided by real-time cardiovascular magnetic resonance

Radiol Med. 2024 Dec;129(12):1823-1829. doi: 10.1007/s11547-024-01911-x. Epub 2024 Nov 7.

Abstract

Cardiovascular magnetic resonance (CMR) is gaining ground in guiding electrophysiology (EP)-based ablation procedures of typical atrial flutter and atrial fibrillation, allowing for the avoidance of radiation exposure for patients and operators and reducing the risk of occupational illnesses. CMR allows comprehensive assessment of cardiac anatomy and provides tissue characterization by identifying pathological substrates, such as myocardial scars and edema, identified with the implementation of late gadolinium enhancement and T2-weighted short-tau inversion recovery sequences. Intraprocedural imaging is useful for real-time catheter tracking during the ablation procedure while simultaneously providing visualization of cardiac anatomy. Additionally, CMR facilitates the evaluation of the ablation procedure accuracy by acquiring edema-sensitive sequences, thereby aiding in preventing early complications. This report serves as a primer for radiologists and illustrates the value of CMR in planning and performing the ablation procedure, as well as its role in post-procedural imaging.

Keywords: Ablation; Cardiac imaging techniques; Heart; Intracardiac electrophysiology techniques; Magnetic resonance imaging.

Publication types

  • Review

MeSH terms

  • Atrial Fibrillation* / diagnostic imaging
  • Atrial Fibrillation* / surgery
  • Atrial Flutter / diagnostic imaging
  • Atrial Flutter / surgery
  • Catheter Ablation / methods
  • Contrast Media
  • Humans
  • Magnetic Resonance Imaging / methods
  • Magnetic Resonance Imaging, Interventional* / methods
  • Radiofrequency Ablation / methods

Substances

  • Contrast Media