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https://doi.org/10.15836/ccar2024.623

Patient approach during invasive electrophysiology procedures guided by magnetic resonance imaging

Ivica Benko orcid id orcid.org/0000-0002-1878-0880 ; Dubrava University Hospital, Zagreb, Croatia
Mateja Lovrić orcid id orcid.org/0000-0003-1457-6521 ; Dubrava University Hospital, Zagreb, Croatia
Marina Budetić orcid id orcid.org/0000-0002-1165-7097 ; Dubrava University Hospital, Zagreb, Croatia
Mirela Adamović orcid id orcid.org/0000-0003-4922-7436 ; Dubrava University Hospital, Zagreb, Croatia
Nikolina Slamek orcid id orcid.org/0000-0002-2975-8793 ; Dubrava University Hospital, Zagreb, Croatia
Marina Žanić orcid id orcid.org/0000-0001-5123-8586 ; Dubrava University Hospital, Zagreb, Croatia
Marija Grlić orcid id orcid.org/0000-0002-4288-9659 ; Dubrava University Hospital, Zagreb, Croatia
Ivan Horvat orcid id orcid.org/0000-0002-0480-7341 ; Dubrava University Hospital, Zagreb, Croatia
Mario Tomašević orcid id orcid.org/0000-0003-0931-9272 ; Dubrava University Hospital, Zagreb, Croatia
Nikolina Gracić orcid id orcid.org/0009-0000-2806-8822 ; Dubrava University Hospital, Zagreb, Croatia
Tomislav Delić orcid id orcid.org/0009-0005-9168-0615 ; Dubrava University Hospital, Zagreb, Croatia
Ante Lisičić orcid id orcid.org/0000-0002-4365-9652 ; Dubrava University Hospital, Zagreb, Croatia
Ivan Zeljković orcid id orcid.org/0000-0002-4550-4056 ; Dubrava University Hospital, Zagreb, Croatia
Nikola Pavlović orcid id orcid.org/0000-0001-9187-7681 ; Dubrava University Hospital, Zagreb, Croatia
Ana Jordan orcid id orcid.org/0000-0001-5610-6259 ; Dubrava University Hospital, Zagreb, Croatia
Šime Manola orcid id orcid.org/0000-0001-6444-2674 ; Dubrava University Hospital, Zagreb, Croatia


Puni tekst: engleski pdf 144 Kb

str. 623-623

preuzimanja: 138

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Sažetak

Ključne riječi

electrophysiology procedures; magnetic resonance imaging; multidisciplinary team

Hrčak ID:

328959

URI

https://hrcak.srce.hr/328959

Datum izdavanja:

13.12.2024.

Posjeta: 395 *



Conventional electrophysiology (EP) interventions are typically performed in specialized EP labs, where fluoroscopy is the main imaging method for catheter placement. Due to the risks of ionizing radiation, staff must wear protective equipment. In contrast, magnetic resonance imaging (MRI) -guided EP procedures present a novel, radiation-free alternative with superior anatomical visualization. Preparing patients for MRI-guided EP procedures requires a coordinated multidisciplinary team, including physicians, engineers, radiology technologists, and nurses. This team is responsible for conducting safety assessments, monitoring vital signs, and managing MRI-compatible medical equipment. Nurses and radiology technologists face specific challenges in the MRI environment, which demands expertise not typically required in conventional settings. Patient preparation begins with detailed education about the procedure and MRI safety protocols. The nurse ensures that there are no contraindications, such as metal implants, and carries out standard preparations, including intravenous line placement and setting up MRI-safe monitoring devices. During the procedure, continuous monitoring requires specialized MRI-compatible equipment. The nurse also manages emergency equipment, such as defibrillators and infusion pumps, positioned outside the magnetic zone. In case of emergencies, such as intubation or defibrillation, interventions must be performed outside the MRI suite. Given the invasive nature of these procedures, maintaining strict hygiene and aseptic conditions are crucial. Throughout the procedure, nurses collaborate closely with radiology technologists to ensure seamless communication with physicians inside the MRI room, using specialized optoacoustic headsets for synchronized execution of all steps. MRI-guided EP procedures, such as atrial flutter ablation, achieve comparable outcomes to conventional methods, with the added benefits of reduced radiation exposure and enhanced anatomical precision. However, performing these procedures outside the traditional fluoroscopy lab presents technical, practical, and safety challenges, which require the expertise of a dedicated and experienced multidisciplinary team. (1,2)

LITERATURE

1 

Bijvoet GP, Holtackers RJ, Smink J, Lloyd T, van den Hombergh CLM, Debie LJBM, et al. Transforming a pre-existing MRI environment into an interventional cardiac MRI suite. J Cardiovasc Electrophysiol. 2021 August;32(8):2090–6. https://doi.org/10.1111/jce.15128 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/34164862

2 

Paetsch I, Jahnke C, Hilbert S, Krueger S, Weiss S, Smink J, et al. Cardiovascular Magnetic Resonance-Guided Electrophysiological Interventions: Radiofrequency Ablation of Typical Atrial Flutter. Circ Cardiovasc Imaging. 2017 January;10(1):e005780. https://doi.org/10.1161/CIRCIMAGING.116.005780 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/28028014


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