Magnetic resonance guided radiofrequency ablation: Creation and visualization of cardiac lesions

Abstract

Current management of atrial fibrillation (AF) refractory to pharmacological therapy involves the creation of lines of conduction block in the atrial tissue either by direct surgical incision or fluoroscopy guided radiofrequency (RF) ablation. While these techniques have been shown to be effective in terminating atrial fibrillation, open heart surgery carries considerable inherent risk and fluoroscopy guided approaches are technically difficult and result in extremely long radiation exposure times. Magnetic resonance (MR) guided ablation therapy may represent a safer and more practical alternative for creating lines of conduction block in patients with AF. We have developed a novel MR compatible system that permits simultaneous high resolution MR imaging, cardiac electrical mapping, and RF energy delivery. This system has, for the first time, made it possible to perform a comprehensive MR guided electrophysiology study including guidance, delivery, and monitoring of cardiac ablation therapy.