Abstract
AimsTo illustrate the practical and technical challenges along with the safety aspects when performing MRIâguided electrophysiological procedures in a preâexisting diagnostic magnetic resonance imaging (MRI) environment.Methods and ResultsA dedicated, wellâtrained multidisciplinary interventional cardiac MRI team (iCMR team), consisting of electrophysiologists, imaging cardiologists, radiologists, anaesthesiologists, MRI physicists, electrophysiological (EP) and MRI technicians, biomedical engineers, and medical instrumentation technologists is a prerequisite for a safe and feasible implementation of CMRâguided electrophysiological procedures (iCMR) in a preâexisting MRI environment. A formal dry run âmockâupâ to address the entire spectrum of technical, logistic, and safety issues was performed before obtaining final approval of the Board of Directors. With this process we showed feasibility of our workflow, safety protocol, and bailout procedures during iCMR outside the conventional EP lab. The practical aspects of performing iCMR procedures in a preâexisting MRI environment were addressed and solidified. Finally, the influence on neighbouring MRI scanners was evaluated, showing no interference.ConclusionTransforming a preâexisting diagnostic MRI environment into an iCMR suite is feasible and safe. However, performing iCMR procedures outside the conventional fluoroscopic lab, poses challenges with technical, practical, and safety aspects that need to be addressed by a dedicated multiâdisciplinary iCMR team.
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