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Active Tracking-based cardiac triggering for MR-thermometry during radiofrequency ablation therapy in the left ventricle

Cardiac MR thermometry shows promise for real-time guidance of radiofrequency ablation of cardiac arrhythmias. This technique uses ECG triggering, which can be unreliable in this situation. A prospective cardiac triggering method was developed for MR thermometry using the active tracking (AT) signal...

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Autores principales: Mooiweer, Ronald, Schneider, Rainer, Krafft, Axel Joachim, Empanger, Katy, Stroup, Jason, Neofytou, Alexander Paul, Mukherjee, Rahul K., Williams, Steven E., Lloyd, Tom, O'Neill, Mark, Razavi, Reza, Schaeffter, Tobias, Neji, Radhouene, Roujol, Sébastien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9453599/
https://www.ncbi.nlm.nih.gov/pubmed/36093156
http://dx.doi.org/10.3389/fcvm.2022.971869
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author Mooiweer, Ronald
Schneider, Rainer
Krafft, Axel Joachim
Empanger, Katy
Stroup, Jason
Neofytou, Alexander Paul
Mukherjee, Rahul K.
Williams, Steven E.
Lloyd, Tom
O'Neill, Mark
Razavi, Reza
Schaeffter, Tobias
Neji, Radhouene
Roujol, Sébastien
author_facet Mooiweer, Ronald
Schneider, Rainer
Krafft, Axel Joachim
Empanger, Katy
Stroup, Jason
Neofytou, Alexander Paul
Mukherjee, Rahul K.
Williams, Steven E.
Lloyd, Tom
O'Neill, Mark
Razavi, Reza
Schaeffter, Tobias
Neji, Radhouene
Roujol, Sébastien
author_sort Mooiweer, Ronald
collection PubMed
description Cardiac MR thermometry shows promise for real-time guidance of radiofrequency ablation of cardiac arrhythmias. This technique uses ECG triggering, which can be unreliable in this situation. A prospective cardiac triggering method was developed for MR thermometry using the active tracking (AT) signal measured from catheter microcoils. In the proposed AT-based cardiac triggering (AT-trig) sequence, AT modules were repeatedly acquired to measure the catheter motion until a cardiac trigger was identified to start cardiac MR thermometry using single-shot echo-planar imaging. The AT signal was bandpass filtered to extract the motion induced by the beating heart, and cardiac triggers were defined as the extremum (peak or valley) of the filtered AT signal. AT-trig was evaluated in a beating heart phantom and in vivo in the left ventricle of a swine during temperature stability experiments (6 locations) and during one ablation. Stability was defined as the standard deviation over time. In the phantom, AT-trig enabled triggering of MR thermometry and resulted in higher temperature stability than an untriggered sequence. In all in vivo experiments, AT-trig intervals matched ECG-derived RR intervals. Mis-triggers were observed in 1/12 AT-trig stability experiments. Comparable stability of MR thermometry was achieved using peak AT-trig (1.0 ± 0.4°C), valley AT-trig (1.1 ± 0.5°C), and ECG triggering (0.9 ± 0.4°C). These experiments show that continuously acquired AT signal for prospective cardiac triggering is feasible. MR thermometry with AT-trig leads to comparable temperature stability as with conventional ECG triggering. AT-trig could serve as an alternative cardiac triggering strategy in situations where ECG triggering is not effective.
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spelling pubmed-94535992022-09-09 Active Tracking-based cardiac triggering for MR-thermometry during radiofrequency ablation therapy in the left ventricle Mooiweer, Ronald Schneider, Rainer Krafft, Axel Joachim Empanger, Katy Stroup, Jason Neofytou, Alexander Paul Mukherjee, Rahul K. Williams, Steven E. Lloyd, Tom O'Neill, Mark Razavi, Reza Schaeffter, Tobias Neji, Radhouene Roujol, Sébastien Front Cardiovasc Med Cardiovascular Medicine Cardiac MR thermometry shows promise for real-time guidance of radiofrequency ablation of cardiac arrhythmias. This technique uses ECG triggering, which can be unreliable in this situation. A prospective cardiac triggering method was developed for MR thermometry using the active tracking (AT) signal measured from catheter microcoils. In the proposed AT-based cardiac triggering (AT-trig) sequence, AT modules were repeatedly acquired to measure the catheter motion until a cardiac trigger was identified to start cardiac MR thermometry using single-shot echo-planar imaging. The AT signal was bandpass filtered to extract the motion induced by the beating heart, and cardiac triggers were defined as the extremum (peak or valley) of the filtered AT signal. AT-trig was evaluated in a beating heart phantom and in vivo in the left ventricle of a swine during temperature stability experiments (6 locations) and during one ablation. Stability was defined as the standard deviation over time. In the phantom, AT-trig enabled triggering of MR thermometry and resulted in higher temperature stability than an untriggered sequence. In all in vivo experiments, AT-trig intervals matched ECG-derived RR intervals. Mis-triggers were observed in 1/12 AT-trig stability experiments. Comparable stability of MR thermometry was achieved using peak AT-trig (1.0 ± 0.4°C), valley AT-trig (1.1 ± 0.5°C), and ECG triggering (0.9 ± 0.4°C). These experiments show that continuously acquired AT signal for prospective cardiac triggering is feasible. MR thermometry with AT-trig leads to comparable temperature stability as with conventional ECG triggering. AT-trig could serve as an alternative cardiac triggering strategy in situations where ECG triggering is not effective. Frontiers Media S.A. 2022-08-25 /pmc/articles/PMC9453599/ /pubmed/36093156 http://dx.doi.org/10.3389/fcvm.2022.971869 Text en Copyright © 2022 Mooiweer, Schneider, Krafft, Empanger, Stroup, Neofytou, Mukherjee, Williams, Lloyd, O'Neill, Razavi, Schaeffter, Neji and Roujol. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Mooiweer, Ronald
Schneider, Rainer
Krafft, Axel Joachim
Empanger, Katy
Stroup, Jason
Neofytou, Alexander Paul
Mukherjee, Rahul K.
Williams, Steven E.
Lloyd, Tom
O'Neill, Mark
Razavi, Reza
Schaeffter, Tobias
Neji, Radhouene
Roujol, Sébastien
Active Tracking-based cardiac triggering for MR-thermometry during radiofrequency ablation therapy in the left ventricle
title Active Tracking-based cardiac triggering for MR-thermometry during radiofrequency ablation therapy in the left ventricle
title_full Active Tracking-based cardiac triggering for MR-thermometry during radiofrequency ablation therapy in the left ventricle
title_fullStr Active Tracking-based cardiac triggering for MR-thermometry during radiofrequency ablation therapy in the left ventricle
title_full_unstemmed Active Tracking-based cardiac triggering for MR-thermometry during radiofrequency ablation therapy in the left ventricle
title_short Active Tracking-based cardiac triggering for MR-thermometry during radiofrequency ablation therapy in the left ventricle
title_sort active tracking-based cardiac triggering for mr-thermometry during radiofrequency ablation therapy in the left ventricle
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9453599/
https://www.ncbi.nlm.nih.gov/pubmed/36093156
http://dx.doi.org/10.3389/fcvm.2022.971869
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