The role of cardiac mri in the treatment of patients with atrial arrhythmias

This thesis investigated the role of cardiac MRI in the treatment of patients with atrial arrhythmias. The first part of the dissertation focuses on diagnostics. Systematic literature review shows that MRI findings correspond with internally measured electrical signals in the atrium. By non-invasively assessing the structure of the atrium, a better treatment strategy may be chosen. To this end, the optimal cut-off value was determined for previous ablation scar in the atrium, when using a new MRI technique ('dark-blood LGE MRI'). The second part of the thesis focuses on the innovative treatment: interventional cardiac MRI (iCMR) catetheter ablation. MRI is used for both direct guidance and direct evaluation of the ablation treatment. This thesis demonstrated the feasibility and safety of this procedure in a fully transformed, conventional MRI environment, while amidst multiple active MRI scanners. The thesis also provided standard iCMR procedural and safety protocols, and a complete overview of iCMR catheter navigation techniques. Finally, this thesis demonstrated that a specific MRI sequence (T1 mapping) of the right atrium is possible and identifies areas requiring additional ablation after iCMR catheter ablation of CTI-related atriale flutter. If future research confirms this, this may improve the success rate of ablations.