Pranav Bhagirath

212 Chapter 11 A larger prospective study to investigate the cost-efficiency and clinical efficacy of this workup and stratification approach is currently being planned and would support the rationale for routine clinical use. Future perspectives Interventional CMR (iCMR) is an emerging technology and is assigned an important role in the field of Electrophysiology (EP) 10 . 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 this information could potentially improve the EP procedure by reducing procedural time and increasing (therapeutic) efficacy, including less redo procedures. An increasing number of iCMR guided EP procedures have been conducted over the past 5 years 11-26 . So far, the limited number of (safety) studies conducted in humans have been successful and uncomplicated. However, there are still a few major challenges to overcome prior to performing complex ablation procedures in the MRI environment; 1) MRI compatible equipment (12 lead ECG, catheters and ablation systems) with regulatory approval is needed, and 2) emergency strategies especially regarding defibrillation inside the MRI have to be established. The coming years should be targeted at resolving these issues in order to expedite the clinical transition of ablation procedures towards iCMR. Finally, the complete integration of non-invasively obtained anatomical data with tissue characteristics and its electrical behavior will demonstrate the full strength of such an iCMR approach. DESIGN AND VALIDATION OF AN INVERSE POTENTIAL MAPPING METHOD Non-invasive imaging of cardiac electrophysiology using inverse potential mapping (IPM) is considered a promising tool to complement conventional (invasive) electrophysiological study, despite challenges such as selecting appropriate source and volume conductor models and a continuing need for validation in humans. The second part of the research was focused on developing and evaluating a clinically applicable whole-heart workflow, integrating IPM and cardiac activation simulations.