Fully CMR-guided electrophysiological interventions (EP-CMR) have recently been introduced but data on the optimal CMR imaging protocol are scarce. This study determined the clinical utility of 3D non-selective whole heart steady-state free precession imaging using compressed SENSE (nsWHcs) for automatic segmentation of cardiac cavities as the basis for targeted catheter navigation during EP-CMR cavo-tricuspid isthmus ablation. Fourty-two consecutive patients with isthmus-dependent right atrial flutter underwent EP-CMR radiofrequency ablations. nsWHcs succeeded in all patients (nominal scan duration, 98 ± 10 s); automatic segmentation/generation of surface meshes of right-sided cavities exhibited short computation times (16 ± 3 s) with correct delineation of right atrium, right ventricle, tricuspid annulus and coronary sinus ostium in 100%, 100%, 100% and 95%, respectively. Point-by-point ablation adhered to the predefined isthmus line in 62% of patients (26/42); activation mapping confirmed complete bidirectional isthmus block (conduction time difference, 136 ± 28 ms). nsWHcs ensured automatic and reliable 3D segmentation of targeted endoluminal cavities, multiplanar reformatting and image fusion (e.g. activation time measurements) and represented the basis for precise real-time active catheter navigation during EP-CMR ablations of isthmus-dependent right atrial flutter. Hence, nsWHcs can be considered a key component in order to advance EP-CMR towards the ultimate goal of targeted substrate-based ablation procedures.

最近引入了完全 CMR 引导的电生理干预 (EP-CMR)，但有关最佳 CMR 成像方案的数据很少。本研究确定了使用压缩 SENSE (nsWHcs) 进行心腔自动分割的 3D 非选择性全心稳态自由进动成像的临床实用性，作为 EP-CMR 腔三尖瓣峡部消融期间靶向导管导航的基础。连续 42 名患有峡部依赖性右心房扑动的患者接受了 EP-CMR 射频消融术。 nsWHcs 在所有患者中均取得成功（标称扫描持续时间，98 ± 10 秒）；自动分割/生成右侧腔表面网格，计算时间短（16 ± 3 s），正确描绘右心房、右心室、三尖瓣环和冠状窦口，分别为 100%、100%、100% 和 95% ， 分别。 62% 的患者 (26/42) 的逐点消融遵循预定的峡部线；激活图证实完全双向峡部阻滞（传导时间差，136 ± 28 ms）。 nsWHcs 确保了目标腔内自动、可靠的 3D 分割、多平面重新格式化和图像融合（例如激活时间测量），并为峡部依赖性右心房扑动的 EP-CMR 消融过程中精确实时主动导管导航奠定了基础。因此，nsWHcs 可以被认为是推动 EP-CMR 实现基于基质的靶向消融程序的最终目标的关键组成部分。