Pranav Bhagirath

34 Chapter 2 Currently, the most promising modality seems to be CMR. Although it is the least frequently used due to time constraints and restrictions for some patient groups. Nevertheless, its ability to visualize anatomy combined with information about tissue characteristics enable a detailed workup to be performed. Using pre-procedurally acquired imaging data to guide ablation, results in lower radiation exposure and possible increase of therapeutic efficacy. A baseline for future follow-up examinations is established simultaneously. Recent studies revealed the possibility for identifying potential interruptions of ablation lesions, so called electrical gaps which can be used to guide redo ablative procedures (9;28) . Gap identification, quantification of LA structural remodeling (volume, sphericity) and PV flow measurements allow for a thorough evaluation of procedural efficacy and related complications. Furthermore, CMR does not expose patients to radiation making it safe for (routine) follow-up. Minor contraindications like claustrophobia can be counteractedwith an anxiolytic. Free breathing and motion correction techniques are used to optimize image acquisition and reduce artifacts for challenging patients presenting with dyspnea and arrhythmia (51) . CONCLUSION Multimodality imaging to guide catheter ablation therapy is not preferable for high volume institutes. Modern day healthcare demands a single technique, both cost- and time-efficient, that performs the complete workup of a patient for catheter ablation. CMR has shown to be comparable to the key imaging modalities, providing all the information during a single examination, in a safe and reproducible manner. In addition it seems to be more cost-effective. These conditions endorse this modality for a single technique approach.