Towards MR-guided Pulsed Field Ablation: Lesion Characterization with LGE and Demonstration of an MR-compatible Interventional Setup

Motivation: Pulsed field ablation (PFA) is a promising, safer alternative to conventional methods for treating cardiac arrhythmias. However, optimizing lesion formation remains a challenge. Goal(s): To assess PFA-induced lesion constitution in a pig model using high-resolution ex vivo MRI and to demonstrate the feasibility of MR-guided PFA. Approach: Ex vivo LGE and R2* imaging was performed after successful creation of PFA lesions in a pig. MR-guided PFA tested in vitro. Results: The size and constitution of PFA lesions could be measured on ex vivo LGE and R2* images. MR-guided ablation was possible in vitro with the demonstrated setup. Impact: High-resolution ex vivo MRI accurately assesses pulsed field induced ablation lesions in a porcine model, providing valuable insights for optimizing PFA lesion formation to treat cardiac arrhythmia. MR-guided PFA is demonstrated to be feasible, which could enable real-time lesion monitoring.