TY - JOUR T1 - Epicardial electroanatomical mapping, radiofrequency ablation, and lesion imaging in the porcine left ventricle under real-time magnetic resonance imaging guidance-an in vivo feasibility study. AU - Mukherjee,Rahul K, AU - Roujol,Sébastien, AU - Chubb,Henry, AU - Harrison,James, AU - Williams,Steven, AU - Whitaker,John, AU - O'Neill,Louisa, AU - Silberbauer,John, AU - Neji,Radhouene, AU - Schneider,Rainer, AU - Pohl,Thomas, AU - Lloyd,Tom, AU - O'Neill,Mark, AU - Razavi,Reza, PY - 2017/06/30/received PY - 2017/10/16/accepted PY - 2018/1/3/pubmed PY - 2019/6/14/medline PY - 2018/1/3/entrez SP - f254 EP - f262 JF - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology JO - Europace VL - 20 IS - FI2 N2 - Aims: Magnetic resonance imaging (MRI) is the gold standard for defining myocardial substrate in 3D and can be used to guide ventricular tachycardia ablation. We describe the feasibility of using a prototype magnetic resonance-guided electrophysiology (MR-EP) system in a pre-clinical model to perform real-time MRI-guided epicardial mapping, ablation, and lesion imaging with active catheter tracking. Methods and results: Experiments were performed in vivo in pigs (n = 6) using an MR-EP guidance system research prototype (Siemens Healthcare) with an irrigated ablation catheter (Vision-MR, Imricor) and a dedicated electrophysiology recording system (Advantage-MR, Imricor). Following epicardial access, local activation and voltage maps were acquired, and targeted radiofrequency (RF) ablation lesions were delivered. Ablation lesions were visualized in real time during RF delivery using MR-thermometry and dosimetry. Hyper-acute and acute assessment of ablation lesions was also performed using native T1 mapping and late-gadolinium enhancement (LGE), respectively. High-quality epicardial bipolar electrograms were recorded with a signal-to-noise ratio of greater than 10:1 for a signal of 1.5 mV. During epicardial ablation, localized temperature elevation could be visualized with a maximum temperature rise of 35 °C within 2 mm of the catheter tip relative to remote myocardium. Decreased native T1 times were observed (882 ± 107 ms) in the lesion core 3-5 min after lesion delivery and relative location of lesions matched well to LGE. There was a good correlation between ablation lesion site on the iCMR platform and autopsy. Conclusion: The MR-EP system was able to successfully acquire epicardial voltage and activation maps in swine, deliver, and visualize ablation lesions, demonstrating feasibility for intraprocedural guidance and real-time assessment of ablation injury. SN - 1532-2092 UR - https://www.unboundmedicine.com/medline/citation/29294008/Epicardial_electroanatomical_mapping_radiofrequency_ablation_and_lesion_imaging_in_the_porcine_left_ventricle_under_real_time_magnetic_resonance_imaging_guidance_an_in_vivo_feasibility_study_ DB - PRIME DP - Unbound Medicine ER -