Ablation of Ventricular and Atrial Arrhythmias in the Era of Cardiac Magnetic Resonance

Pietro Costantini*, Francesca Coraducci, Giulia De Zan, Damiano Fedele, Eleonora Ostillio, Riccardo Bertozzi, Federico Donato, Giuseppe Muscogiuri, Anna Giulia Pavon, Luca Bergamaschi, Carmine Pizzi, Astrid Hendriks, Anneline S J M Te Riele, Dominika Suchá, Sophie Rier, Pim van der Harst, Birgitta Velthuis, Ivo van der Bilt, Anna Colarieti, Alessandro CarrieroMarco Guglielmo*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

In the past decade, cardiac magnetic resonance (CMR) has undergone remarkable progress, emerging as a pivotal tool in various cardiological scenarios. Its capacity for tissue characterization, both with and without contrast agents, makes CMR the perfect tool to study the substrate of arrhythmia. This review highlights the potential role of CMR in electrophysiology (EP) and its role in the ablation of atrial and ventricular arrhythmias. First, we will discuss the key aspects of ventricular arrhythmia ablation, while in the second part, we will review how CMR is changing the ablation of atrial arrhythmias. The potentiality of CMR in the pre-procedural, intra-procedural, and post-ablation assessment will be reviewed. In particular, CMR is capable of visualizing fibrosis and building 3D reconstruction. Furthermore, it is possible to merge a 3D-rendered shell of the heart into the EP room to guide radiation-free ablation through active or passive tracking. Finally, the accuracy of CMR in depicting ablation lesions and its ability to predict arrhythmia relapses will be discussed.

Original languageEnglish
Article numbere70150
JournalEchocardiography
Volume42
Issue number4
DOIs
Publication statusPublished - Apr 2025

Keywords

  • Arrhythmias, Cardiac/surgery
  • Atrial Fibrillation/surgery
  • Catheter Ablation/methods
  • Heart Atria/surgery
  • Heart Ventricles/surgery
  • Humans
  • Magnetic Resonance Imaging, Cine/methods
  • Magnetic Resonance Imaging/methods
  • Tachycardia, Ventricular/surgery

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