Pranav Bhagirath

123 Interventional cardiac magnetic resonance imaging in electrophysiology: advances toward clinical translation (visualization planes) of the operating physician and 3) allowing the interventionalist to get used to the benefits (no heavy lead protection) and limitations associated with procedures in the iCMR. Once the necessary experience is acquired, these procedures can be replaced by electrophysiological interventions with simple catheter setups e.g. atrial flutter ablation. Prior to applying iCMR in complex ablations (atrial fibrillation and ventricular tachycardia) fundamental obstacles e.g. commercial 12 lead ECG system and defibrillation need to be resolved. New challenges - competitive methods Besides the tissue characteristic based road-map, non-invasively obtained inverse potential maps (IPM) generated from body surface potential mapping (BSPM) may reduce procedural duration and improve outcome 51 . IPM is already being applied to analyze complex arrhythmias and has great potential to generate personalized ablation strategies 52 . The anatomical volume conductor models required to perform IPM can also be used for preparing a patient-specific procedural roadmap ( figure 4 ). Inverse potential map Invasive EAM RVOT Premature Ventricular Contraction Figure 4. Inverse potential map of an RVOT premature ventricular contraction. Left panel indicates the first point of activation (black) during a PVC. Right panel shows the focus of activation as measured during invasive EP study. There is significant visual agreement between the two images. This indicates the potential of IPM as a pre-procedural diagnostic modality.