Authors

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

Keywords

electrophysiology procedures, magnetic resonance imaging, multidisciplinary team

DOI

Full Text

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
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