Image-Guided Cardiac Electrophysiology Procedures Focusing on MRI Guidance

Image-Guided Cardiac EP Procedures
  • Ehud J. SchmidtEmail author
  • Charles L. Dumoulin
  • Stephan A. Danik


Cardiac electrophysiology (EP) is a rapidly growing field, a result of the large and growing number of patients suffering from atrial fibrillation (AF) and ventricular tachycardia (VT). The success rate of ablation in patients with paroxysmal and persistent AF is approximately 70 % and 50 %, respectively; while in those with scar-related ventricular tachycardia, the success rate is approximately 50 %. As a result, there is a need for improved procedural techniques and a deeper understanding of recurrences in failed procedures. The field of EP has generated considerable industrial interest, so that the field is highly advanced technologically and uses tools that are not frequently seen in other surgical or interventional fields.

MR imaging offers unique solutions to several current EP procedural limitations, by providing robust multi-contrast imaging of the cardiac chambers’ lumen and wall. As a result, cardiac-MRI imaging has grown in prominence as a pre- and post-procedural EP tool. We cover the growth of MRI in these applications and then discuss the more complex issues entailed in performance of intra-procedural MRI, which may greatly improve EP outcomes and is a topic of extensive present research. We discuss the requirements of intra-procedural MRI and demonstrate one system built to address these needs.

We discuss applications in which preclinical and clinical results have already been obtained using intra-procedural MRI. We also present emerging MRI sequences and clinical applications which may further extend the utility of MRI-guided EP.


Atrial Fibrillation Ventricular Tachycardia Late Gadolinium Enhancement Atrial Fibrillation Ablation Ablation Lesion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We gratefully acknowledge funding from AHA SDG 10S0G2610139, NCRR/NCI 1P41RR019703-01A2, NHLBI R43 HL110427-01, and NHLBI K23 HL68064. We would also like to thank all of those who kindly provided us with images.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Ehud J. Schmidt
    • 1
    Email author
  • Charles L. Dumoulin
    • 2
  • Stephan A. Danik
    • 3
  1. 1.National Center for Image Guided Therapy, Department of RadiologyBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Department of RadiologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  3. 3.Department of CardiologyMassachusetts General HospitalBostonUSA

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