Combining MRI Intelligence and Therapeutic Expertise

Magnetic Resonance Imaging (MRI) can provide information to support diagnosis and treatment in cardiac ablation and device therapy. Pre-procedural application involves assessment of 3D anatomy und underlying heart disease, but also identification of cardiac substrates relevant for the occurrence and maintenance of arrhythmias, such as scars in patients with ventricular tachycardia (VT) or fibrosis in patients with atrial fibrillation (AF). This can improve arrhythmic risk assessment (e.g. for SCD), as well as patient identification and supports the decision whether and how to implant devices, e.g. for CRT or ICDs. Recent advancements in MR-compatible catheter technology commence a new era. Clinical studies describe real-time 3D catheter guidance and direct visualization of lesion formation under MRI control. Thus, MRI is highly promising to facilitate radiation-free ablation procedures in the future. Post-procedural MRI could help to assess the effect of ablation on cardiac size and function, to visualize completeness and transmurality of ablation lesions and – last but not least – to screen for complications such as pulmonary vein stenosis or oesophageal injury, especially after complex cases.