Arrhythmias & electrophysiology
Interventional cardiac magnetic resonance-guided flutter ablation: Technical evolution and procedural insights from early clinical use
Authors' conclusion
iCMR-guided CTI ablation was feasible and could be performed safely using both ACI and ACT. However, procedural complexity, prolonged procedure times, and recurrence rates reflect the early implementation phase of this first-generation iCMR platform. Ongoing advances in catheter technology, system integration, and workflow optimization are expected to further improve procedural performance and support broader clinical adoption.
Study context
- Population
- Patients who underwent real-time iCMR-guided cavotricuspid isthmus (CTI) ablation for typical atrial flutter between September 2022 and February 2025
- Participants
- 35 consecutive patients
- Exposure
- Active catheter imaging vs active catheter tracking
- Active catheter imaging (ACI)n = 15
- Active catheter tracking (ACT)n = 20
- Outcome
- Acute bidirectional CTI block
Methodological detailssingle-center cohort, consecutive patients
- Single-center cohort
- Consecutive patients
Main finding
As reported in the abstract
Acute bidirectional CTI block confirmed
32 of 35 patients
91%
Observational data: associations, not effects.
Further findings
Procedure duration
P = 0.07
| Outcome | ACI | ACT | P value |
|---|---|---|---|
| Typical atrial flutter recurrence · 1-year follow-upNo difference | 4 of 15 patients events | 2 of 17 patients events | log-rank P = .29 |
- Typical atrial flutter recurrence — Recurrence among patients with confirmed CTI block
- 6 of 32 patients (19%)
Procedural or technical challenges
- Procedural or technical challenges occurred
- 19 patients (54%)
- Most commonly related to coronary sinus catheter positioning and workflow or system-integration issues
Baseline characteristics
- Mean age
- 66 ± 7 years
- Women
- 9%
Original publication
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