Interventional Cardiovascular Magnetic Resonance (iCMR) Guided Flutter Ablation: A Two-Year Review of Safety and Efficacy Insights

Saturday, February 1, 2025

9:37 AM – 9:46 AM East Coast USA Time

Location: Diplomat Ballroom

Presenting Author(s)

SS

Soukaina SCADI, MD

Fellow
Hopital Privé Jacques Cartier, Morocco

Primary Author(s)

SS

Soukaina SCADI, MD

Fellow
Hopital Privé Jacques Cartier, Morocco

Co-Author(s)

SD

Suzanne DUHAMEL, MD

Cardiologist
Institut Cardiovasculaire Paris Sud, France
JB

Jonathan BIOLOBRODA, MD

Fellow
Hopital Privé Jacques Cartier, France
LF

Laurent FIORINA, MD

MD
Hopital Privé Jacques Cartier, France
VM

Vladimir MANENTI, MD

MD
Hopital Privé Jacques Cartier, France
FB

François BOUVIER, MD

MD
Hopital Privé Jacques Cartier, France
CC

Charlene COQUARD, MD

MD
Hopital Privé Jacques Cartier, France
MA

Mina Ait Said, MD

Electrophysiologist
Institut Cardiovasculaire Paris Sud, Cardiovascular Magnetic Resonance Laboratory, Hôpital Privé Jacques CARTIER, Massy, France
JH

Jérôme Horvilleur, MD

Electrophysiologist
Institut Cardiovasculaire Paris Sud, Cardiovascular Magnetic Resonance Laboratory, Hôpital Privé Jacques CARTIER, Massy, France
JL

Jérôme Lacotte, MD

Electrophysiologist
Institut Cardiovasculaire Paris Sud, Cardiovascular Magnetic Resonance Laboratory, Hôpital Privé Jacques CARTIER, Massy, France
FS

Fiorella Salerno, MD

Electrophysiologist
Institut Cardiovasculaire Paris Sud, Cardiovascular Magnetic Resonance Laboratory, Hôpital Privé Jacques CARTIER, Massy, France
SY

Salem YOUNSI, MD

MD
Hopital Privé Jacques Cartier, France
FS

Francesca Sanguineti, MD

Cardiologist
Institut Cardiovasculaire Paris Sud, France
PG

Philippe GAROT, MD

MD
Hopital Privé Jacques Cartier, France
CT

Cholé TAWA, MD

MD
Hopital Privé Jacques Cartier, France
AP

Alexandre PFEFFER, MD

MD
Hopital Privé Jacques Cartier, France
Theo Pezel, MD, PhD

Cardiologist
Hôpital Lariboisière – APHP, Paris, France, France
JG

Jérôme GAROT, MD, PhD

head of cardiovascular MR
Cardiovascular Institute Paris Sud (ICPS), France

Background:

The use of interventional cardiovascular magnetic resonance (iCMR)-guided arrhythmia ablations is of growing interest, with the ultimate goal of visualizing and positioning the ablation catheters directly on target areas with late gadolinium enhanced CMR.

Ablation of isthmus-dependent atrial flutter with iCMR has demonstrated its efficacy and safety in the initial phase for achieving bidirectional block. However, limited long-term follow-up data exist for these patients.

Objectives: To determine the safety and accuracy of this technique over 2-year follow- up.

Methods: iCMR-guided ablation procedures were performed in a conventional 1.5-T Siemens MAGNETOM AERA scanner with two MR-conditional ablation catheters under compressed-sensing real-time cine CMR guidance. After the ablation shots, confirmation data of bidirectional block in the cavotricuspid isthmus (CTI) were collected for all patients. Patients received standard follow-up care.

Results:

Thirteen consecutive patients were included between 2021 and 2022 (62% males; median age 76 years; interquartile range [73-78]). All procedures were performed on an outpatient basis. Ablation success was achieved in 11 patients (85%).

CTI ablation had to be completed in a conventional electrophysiology lab in two

patients: one had significant chest pain during CTI ablation and needed general anaesthesia, and the other deteriorated into atrial fibrillation during ablation shots. Among 11 patients with procedural success, 9 (82%) patients had a median follow-up of 27 (IQR 24-29) months, with no recurrence of isthmus-dependent atrial flutter. Two (18%) patients were lost to follow-up after the ablation.

Conclusion: iCMR- guided flutter ablation shows a good safety profile and efficacy at 2-year follow-up.