Preclinical Evaluation of an MR-EP Suite Including an MR-EP Navigator and Dedicated MR-EP Catheters

Sascha Krueger¹, Ronald Holthuizen², Jouke Smink², Steffen Weiss¹, Oliver Lips¹, Bernd David¹, Daniel Wirtz¹, Steen Fjord Pedersen³, Dennis Caulfield⁴, Julian Bostock⁴, Gang Gao⁴, Phani Chinchapatnam⁴, Tobias Schaeffter⁴, Reza Razavi⁴

Cardiac arrhythmias, e.g. atrial fibrillation and ventricular tachycardia, are increasingly treated by electrophysiological (EP) interventions. Applying MR for guiding these interventions offers advantages like 3D visualization of the cardiac soft tissue in relation to the catheter, visualization of the treatment effect and absence of ionizing radiation. Making the step towards clinical MR-guided EP interventions requires a focus on RF safety of the devices, localization accuracy of the catheters, guidance of the procedure, intra-cardiac signal quality and procedure workflow. Here, an MR-EP suite based on an MR-EP Navigator application with a real-time interface to the MR system and therapy equipment is demonstrated along with specialized MR-EP catheters. These catheters are based on RF-safe concepts for both, MR- and EP functionality. RF-safety, localization accuracy and EP signal quality of these devices, and the operation of the MR-EP suite and the workflow of the MR-EP Navigator are demonstrated in a series of pre-clinical MR-guided EP experiments.