Arrhythmias & electrophysiologyCohort study

Interventional cardiac magnetic resonance-guided flutter ablation: Technical evolution and procedural insights from early clinical use

Heart RhythmPublished

  • retrospectively analyzed
  • single-center cohort
  • consecutive patients

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 2025Active catheter imaging (ACI) 15 · active catheter tracking (ACT) 20
Participants
35 consecutive patients
Exposure
active catheter imaging vs active catheter tracking
  • ACIn = 15
  • ACTn = 20

Main finding

As reported in the abstract

Acute bidirectional CTI block

Acute bidirectional CTI block confirmed

32 of 35 patients (91%)

Observational data: associations, not effects.

Further findings

Procedure duration

P = 0.07

OutcomeACIACTP value
Typical atrial flutter recurrence · 1-year follow-up · no difference4 of 15 patients events2 of 17 patients eventslog-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

Interventional cardiac magnetic resonance-guided flutter ablation: Technical evolution and procedural insights from early clinical use. Heart Rhythm. Published 20 July 2026. doi:10.1016/j.hrthm.2026.07.024

Summarised from the published abstract; every number is checked against it