Stereotactic magnetic resonance guidance for anatomically targeted ablations of the fossa ovalis and the left atrium

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
Timm DickfeldStephen B Solomon

Abstract

Targets for radiofrequency ablation (RFA) of atrial fibrillation are increasingly being selected based on anatomic considerations. Because fluoroscopy provides only limited information about the relationship between catheter positions and cardiac structures, we evaluated whether stereotactic catheter guidance might facilitate anatomical catheter navigation and RFA to the great vessels, the fossa ovalis and the left atrium (LA). An electromagnetic catheter's position system was superimposed on three-dimensional (3D) MR images using fiducial markers. This allowed the dynamic display of the catheter position on the true anatomy of previously acquired MRI in real-time. To assess the reproducibility of RFA, repeat ablations were created at the identical anatomic site in the inferior vena cava (IVC) in 5 swine. Average distance of the repeated ablations was 4.4 +/- 2.4 mm.In five swine the catheter was anatomically guided with the MRI to the fossa ovalis and a single RFA was performed. On the pathological specimen all ablation sites were located within the fossa ovalis with an average distance of 3.9 +/- 2.1 mm from its center. In two of the experiments the ablation catheter was passed into the left atrium and anatomically targeted a...Continue Reading

Citations

Sep 25, 2007·Herzschrittmachertherapie & Elektrophysiologie·J Dong, T Dickfeld
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Aug 23, 2006·Topics in Magnetic Resonance Imaging : TMRI·Cengizhan OzturkRobert J Lederman
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Jun 9, 2017·The International Journal of Cardiovascular Imaging·Ehud J Schmidt, Henry R Halperin

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