Breakthrough: Use of MRI in Catheter Ablation for Atrial Fibrillation

November 7, 2008 8:19 AM CT

A team led by Dr. Nassir Marrouche, the Director of the Atrial Fibrillation (AF) Program at the University Of Utah School Of Medicine, is pioneering the use of magnetic resonance imaging (MRI) in catheter ablation, which could represent a breakthrough in the treatment of atrial fibrillation.

Dr. Marrouche presented a study early this year at the American College of Cardiology conference that showed how MRI can be used as a precise, pre-procedure diagnostic tool to demonstrate the progression and location of atrial fibrillation.  

MRI is better than fluoroscopy and CAT scans because it reveals damaged, fibrotic tissue due to atrial fibrillation. Ablation is feasible if less than 50% of the heart is damaged.

Since the MRI lab is adjacent to the catheter lab, they can use MRI to identify whether erratic signals are still present after ablation and go back to the cath lab to ablate further, if necessary.

MRI allows physicians to see if the ablation lesions are deep enough to destroy all the fibrotic heart tissue, but not so deep that they damage the esophagus, which can be a fatal complication.

Dr. Marrouche has done more than 1,000 ablation procedures and used MRI in more than 230 of them. About 90% of his patients are arrhythmia free and off heart medications within three months, with major complication rates 12 times better than the norm in the recent worldwide multicenter study.

Last October, the program became the first ever to be able to use a custom-made catheter compatible with the MRI.

By the end of the year, Marrouche expects to perform the first catheter ablation with simultaneous MRI imaging to allow ablating the precise amount of tissue and avoid complications.

Dr. Marrouche recently joined the University of Utah from the Cleveland Clinic. He and his team recently received the Eric N. Prystowsky Fellow Clinical Research Award at the Heart Rhythm Society’s annual meeting.

Adapted from materials provided by University of Utah Health Sciences.

Read more:  MRI may change heart care