World first: Treatment of cardiac arrhythmias in an MRI scanner

An MRI scanner is normally used primarily for diagnostics. But thanks to new technological possibilities, it is increasingly possible to use a scanner of this type during treatments. This can take shape in various ways. For example, Catharina Hospital recently purchased a new radiation device with a incorporated Magnetic resonance scanner. Thanks to this MRI linac, the doctors of the Catharina Cancer Institute can work even more precisely and radiotherapy is required less often for a number of cancer types. Another MRI option has now been developed in Maastricht which allows ablation therapy for patients with cardiac arrhythmias while the patient lies in an MRI scanner. This new treatment option in the MRI scanner is referred to as interventional cardiac MRI.

No harmful radiation

The advantages of this innovation are many to make known to those involved in the patient website from Maastricht UMC+. ‘An important advantage of this new technique is that the location of the heart muscle tissue to be treated can be better visualized with MRI, so that treatment can be performed more accurately. Additionally, an MRI scanner uses no harmful radiation, which benefits both the patient and the healthcare professional. Furthermore, with this new technique, heart muscle tissue can be immediately remapped after scars have been applied during ablation therapy.’

450,000 cardiac arrhythmias

In the Netherlands, nearly 450,000 people suffer from some form of cardiac arrhythmia each year. Some of them are treated with ablative therapy, especially if the medications don’t work well. In this ablation, the doctor deliberately damages the heart tissue at the site of the arrhythmia by heating or freezing it. This creates scars on the heart that block the electrical impulses that cause arrhythmias. The ablation is done by catheterization or surgery (keyhole), which is now possible while live images are made in the MRI scanner.

Until now, these catheters have been guided through the groin to the heart by X-ray guidance. But frequent exposure to this radiation can be harmful. Several technical innovations now make it possible to perform these treatments in the heart using an MRI scanner.

World premiere for Maastricht UMC+

The new form of interventional cardiac magnetic resonance is truly a world first. While other centers have already performed MRI scanner ablation treatments, Maastricht UMC+ goes one step further. “The combination of advanced software and special catheters makes it possible to visualize the electrical signals from the catheters directly on anatomical MRI images, thus mapping the conduction of electrical currents through the heart. With this, it is possible to create a 3D model of the heart on which the position of the catheters can be followed ‘live’ to perform the treatment even more accurately.’

In order to make this unique method of treating cardiac arrhythmias possible, intensive cooperation is needed on all fronts. Not only between the departments of Cardiology, Imaging, Anesthesia and Medical Instrumentation Technology (MIT) within UMC+ Maastricht, but also the cooperation with business partners Philips Healthcare and IMRICOR. All parties thus largely earned the Team Science Award.