电生理心血管磁共振(EP-CMR)引导的介入手术:挑战与机遇。

IF 3.1 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Current Cardiology Reports Pub Date : 2024-09-01 Epub Date: 2024-07-18 DOI:10.1007/s11886-024-02092-9
Sabrina Oebel, Cosima Jahnke, Kerstin Bode, Ingo Paetsch
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引用次数: 0

摘要

综述目的:心血管磁共振(CMR)成像可提供详细的三维解剖信息和出色的软组织对比度,已成为诊断评估、电生理程序(EP)规划和心房或心室节律紊乱治疗分层的重要工具。基于 CMR 的消融目标识别可能会对现有的介入电生理学概念产生重大影响。为了充分发挥 CMR 成像的固有优势,CMR 引导的消融术(EP-CMR)被认为是最终目标:电生理心血管磁共振(EP-CMR)介入手术最近被引入到 CMR 武器库中:据报道,在一个由 30 名患者组成的单中心系列中,EP-CMR 引导的消融成功率为 93%,与典型心房扑动的传统消融结果相当,而且手术过程和消融时间也相当。然而,要从在介入 CMR 环境中消融典型心房扑动的成熟工作流程转向治疗更复杂的室性心律失常,就需要在导管、鞘和与 CMR 兼容的除颤器设备的开发方面取得技术进步。CMR 成像已成为心律失常标准临床评估的重要诊断工具。之前的研究已经证明了在 CMR 环境下进行电生理介入手术的可行性和安全性,在经验丰富的中心,完全由 CMR 引导的典型心房扑动消融术可以作为常规手术进行。在已建立的工作流程基础上,与 CMR 兼容的新型介入设备的上市可能会最终实现针对室性心律失常的治疗。
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Electrophysiological Cardiovascular Magnetic Resonance (EP-CMR)-Guided Interventional Procedures: Challenges and Opportunities.

Purpose of review: Cardiovascular magnetic resonance (CMR) imaging excels in providing detailed three-dimensional anatomical information together with excellent soft tissue contrast and has already become a valuable tool for diagnostic evaluation, electrophysiological procedure (EP) planning, and therapeutical stratification of atrial or ventricular rhythm disorders. CMR-based identification of ablation targets may significantly impact existing concepts of interventional electrophysiology. In order to exploit the inherent advantages of CMR imaging to the fullest, CMR-guided ablation procedures (EP-CMR) are justly considered the ultimate goal.

Recent findings: Electrophysiological cardiovascular magnetic resonance (EP-CMR) interventional procedures have more recently been introduced to the CMR armamentarium: in a single-center series of 30 patients, an EP-CMR guided ablation success of 93% has been reported, which is comparable to conventional ablation outcomes for typical atrial flutter and procedure and ablation time were also reported to be comparable. However, moving on from already established workflows for the ablation of typical atrial flutter in the interventional CMR environment to treatment of more complex ventricular arrhythmias calls for technical advances regarding development of catheters, sheaths and CMR-compatible defibrillator equipment. CMR imaging has already become an important diagnostic tool in the standard clinical assessment of cardiac arrhythmias. Previous studies have demonstrated the feasibility and safety of performing electrophysiological interventional procedures within the CMR environment and fully CMR-guided ablation of typical atrial flutter can be implemented as a routine procedure in experienced centers. Building upon established workflows, the market release of new, CMR-compatible interventional devices may finally enable targeting ventricular arrhythmias.

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来源期刊
Current Cardiology Reports
Current Cardiology Reports CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
6.20
自引率
2.70%
发文量
209
期刊介绍: The aim of this journal is to provide timely perspectives from experts on current advances in cardiovascular medicine. We also seek to provide reviews that highlight the most important recently published papers selected from the wealth of available cardiovascular literature. We accomplish this aim by appointing key authorities in major subject areas across the discipline. Section editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.
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