Pranav Bhagirath

119 Interventional cardiac magnetic resonance imaging in electrophysiology: advances toward clinical translation SAFETY ANDWORKFLOW IN THE IMR The transition fromconventional fluoroscopicprocedures towards an iCMR suite requires revision of the existing workflow. Cath-lab personnel used to work in a fluoroscopic environment need education about operating in a magnetic field. Furthermore, patient monitoring and safety protocols require thorough revision and scenario training. Architectural layout In contrast to conventional fluoroscopy guided procedures, an intervention in the iCMR suite is bound to more strict rules. The procedures are performed in an environment that is less accessible for personnel since each step closer to the magnet increases the risk of ferro-magnetic interaction. The design of an iCMR suite needs to incorporate various aspects considered daily practice for conventional interventions. This includes but is not limited to 1) patient preparation, 2) access to device storage, 3) sterility and air treatment, and 4) evacuation possibilities in case of an emergency. Each of these aspects needs to be carefully considered and adequately addressed. Personnel During the EP and ablation procedures, an experienced technician, radiologist, or imaging cardiologist needs to be present for image acquisition. During the development phase of an iCMR suite, it is advisable (if not mandatory) to have a knowledgeable physicist present for optimization of imaging sequences used during the procedures. During the initial another potential role during interventions could be that of a safety officer. This person could be appointed as coordinator in case of emergency situations. Once a routine procedural workflow is achieved, a dedicated coordinator may become redundant. Communication An essential part of the ablation procedure is the communication between the electrophysiologists and the technician. The development over the past years has progressed rapidly with commercially available MR-compatible solutions (Opto- acoustics, Clear-com, Gaven).