Electrophysiology Interventional Planning

In congenital heart disease (CHD), magnetic resonance imaging can be useful to depict the anatomy of each individual patient, assess vascular access before ablation, and study the presence of arrhythmogenic substrate. Atrial fibrosis assessment with magnetic resonance (MR) may be useful to study the arrhythmogenic substrate and predict the probability of arrhythmia recurrence. In ventricular arrhythmia, MR can be useful to characterize scar and detect the presence of border zone conducting channels. This technique can be used to identify anatomical isthmuses, which are a frequent cause of ventricular tachycardia in congenital heart patients. This information can be integrated in the electroanatomical mapping and be used to guide ablation. Finally, cardiac resynchronization therapy (CRT) is a promising treatment in CHD patients, although evidence is lacking. In addition to determining left and right ventricular function, cardiac imaging can be useful to guide CRT implant in patients with complex anatomies.