Multifunctional interventional devices for MRI: A combined electrophysiology/MRI catheter

Abstract

The design and application of a two-wire electrophysiology (EP) catheter that simultaneously records the intracardiac electrogram and receives the MR signal for active catheter tracking is described. The catheter acts as a long loop receiver, allowing for visualization of the entire catheter length while simultaneously behaving as a traditional two-wire EP catheter, allowing for intracardiac electrogram recording and ablation. The application of the device is demonstrated by simultaneously tracking the catheter and recording the intracardiac electrogram in canine models using 7 and 10 frame/sec real-time imaging sequences. Using solely MR imaging, the entire catheter was visualized and guided from the jugular vein into the cardiac chambers, where the intracardiac electrogram was recorded. By combining several functions in a single, simple structure, the excellent tissue contrast and functional imaging capabilities of MR can be used to improve the efficacy of EP interventions. This catheter will facilitate MR-guided interventions and demonstrates the design of multifunctional interventional devices for use in MRI. Magn Reson Med 47: 594 -600, 2002.

Electroanatomic Mapping of the Left Ventricle in a Porcine Model of Chronic Myocardial Infarction With Magnetic Resonance–Based Catheter Tracking

“…In the latter approach, the coils are capable of receiving MR signals, either at selected points on the shaft (MR tracking) or through the entire length of the catheter. [11][12][13] The incorporation of MR-compatible electrodes into the catheter to measure intracardiac electrograms and to perform ablations requires care in selecting materials to minimize undesirable interactions with the MR system. 13 MRI-based electrophysiology procedures have not yet been performed in a clinically relevant manner.…”

“…[11][12][13] The incorporation of MR-compatible electrodes into the catheter to measure intracardiac electrograms and to perform ablations requires care in selecting materials to minimize undesirable interactions with the MR system. 13 MRI-based electrophysiology procedures have not yet been performed in a clinically relevant manner. One important aspect of electrophysiology procedures is the ability to navigate a catheter throughout the relevant cardiac chamber and to annotate the contact electrogram information to each location, ie, perform EAM.…”

MR‐trackable intramyocardial injection catheter

“…The catheter could also be modified to measure an endocardial potential (EP), to verify contact with the myocardium, and, perhaps, myocardial viability. An RF splitting circuit, similar to that reported by Susil et al (27), could be implemented to measure the local EP signal at the distal tip of the catheter and confirm the location of the needle within the myocardium.…”

Three-dimensional Rotational Angiography as a Periprocedural Imaging Tool in Atrial Fibrillation Ablation

“…14,15 For these reasons, realtime MRI (RTMRI) has been proposed as a new tool for guiding and monitoring EP procedures and ablations. 16,17 While it is still in an early research phase, currently limited by extensive logistic and infrastructure requirements, technological advancements may well bring RTMRI into the clinical research setting in the near future, at which point additional benefits of MRI such as substrate visualisation may become significant. accurate representation of the LA and its specific anatomic regions in order to enhance procedural safety and efficacy during ablation.…”