Magnetresonanztomografische Untersuchungen in der Diagnostik und Therapie von Rhythmusstörungen

Abstract

Catheter ablation is a first line treatment for many cardiac arrhythmias and is generally performed under x-ray fluoroscopy guidance. However, current techniques for ablation complex arrhythmias such as atrial fibrillation and ventricular tachycardia are associated with suboptimal success rates and prolonged radiation exposure. Preprocedural cardiovascular magnetic resonance images have improved the understanding of the anatomic basis of complex arrhythmias and is widely used in the context of atrial fibrillation ablation or congenital heart disease. A particular strength of late enhancement CMR compared to other imaging modalities is the ability to distinguish viable myocardium from scar and to visualize ablation lesions. Therefore, CMR can be used in VT ablation for visualization of the arrhythmogenic substrate and in atrial fibrillation ablation for detection of incomplete ablation lines. In the future, to image complex arrhythmogenic anatomy and target additional ablation to regions of incomplete lesion formation may improve success rate of any ablation procedure.

The development of real-time CMR may allow a more successful treatment of even complex arrhythmias without exposure to ionizing radiation.

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