Pranav Bhagirath

111 Interventional cardiac magnetic resonance imaging in electrophysiology: advances toward clinical translation Figure 1. Isolation gaps detected using LGE and used for redo ablation guidance. Left panel depicts the first pulmonary vein isolation EAM. Certain gaps are visible between the RF application points (red dots). Center panel demonstrates the scar-map generated using LGE images acquired 3 months post-procedure. Tissue characteristics are color coded; blue is healthy myocardium whereas red defines scar/fibrosis. The black circle demonstrates a good visual correlation between the extent of ablation on the EAM and presence of scar on the LGE. Two major gaps are visible on the scar-map (dashed black circle). During the redo procedure (right panel) these gaps were targeted (dashed black arrow). iCMR IN EP iCMR allows for integrated use of pre-procedural 3D anatomical scans to help guidance of active tracked catheters, peri-procedural interactive multi-planar visualization of relevant anatomy and visualization of the extent of ablation lesion as well as evaluation of complications. The therapeutic strategy incorporating these information could potentially improve the EP procedure by reducing procedural time and increasing (therapeutic) efficacy, including less redo procedures. A limited number of centers have explored the (clinical) possibilities towards performing EP procedures (diagnostic and ablation) in an MRI environment (the vast majority at 1.5 Tesla (T)) ( table 1 ). The majority of these studies have been performed in animals. So far, the limited number of (safety) studies conducted in humans have been successful and uncomplicated. However, each research group concludes that prior to performing iCMR guided ablation procedures on a routine basis, the following challenges need to be overcome; 1) Equipment (e.g. communication headsets, catheters and mapping systems) needs to be modified to ensure MR-compatibility and allow active tracking