{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:06:22Z","timestamp":1786975582170,"version":"build-2736575974"},"reference-count":10,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"\n Importance<\/jats:title>\n Catheter ablation is a cornerstone therapy for symptomatic ventricular arrhythmias, yet current techniques rely on fluoroscopy and electroanatomic mapping, which provide limited soft-tissue detail and expose patients and staff to ionizing radiation. Real-time magnetic resonance (MR)\u2013guided ablation may overcome these limitations by enabling direct visualization of cardiac anatomy, substrate, and lesion formation, all within a radiation-free environment.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To demonstrate the technical feasibility and safety of the first-in-human real-time MR-guided radiofrequency ventricular ablation procedure.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participant<\/jats:title>\n This was a prospective, worldwide-first roll-in case from the ongoing VISABL-VT nonrandomized clinical trial assessing MR-guided radiofrequency ablation of ventricular tachycardia. The procedure and analysis were performed in April 2025 at an academic tertiary care center equipped with a standard 1.5-T MR imaging (MRI) suite and dedicated MR-compatible electrophysiology platform, MR-compatible 12-lead electrocardiographic monitoring and recording system, MR-conditional defibrillator, and real-time catheter tracking integrated with the MRI scanner for synchronized imaging and ablation. The patient was a 73-year-old man with symptomatic, drug-refractory outflow tract premature ventricular complexes (PVCs).<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n The ablation was performed under general anesthesia inside the MRI scanner. Intraprocedurally acquired noncontrast 3-dimensional MR angiographic imaging was used to create an anatomical roadmap for the procedure. Real-time catheter tracking and activation mapping were performed using actively tracked diagnostic and ablation catheters. Mapping identified earliest activation first in the posterior septal right ventricular outflow tract, where ablation transiently suppressed PVCs. Ectopy recurred but was ultimately resolved by ablation performed via a retrograde aortic approach in the left coronary cusp. Lesion formation was confirmed via postprocedural MRI.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Suppression of PVCs and presence or absence of procedural complications.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The procedure was performed under real-time MRI guidance without complications. PVCs were completely suppressed, with no recurrence during 30-minute observation or at 2-month follow-up.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This first-in-human case demonstrates that ventricular ablation can be safely and effectively performed entirely under real-time MR guidance. Further evidence from the VISABL-VT trial will clarify clinical utility and long-term outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamacardio.2025.3000","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T15:00:22Z","timestamp":1758121222000},"page":"1195","source":"Crossref","is-referenced-by-count":7,"title":["First-in-Human Real-Time MR-Guided Ventricular Ablation for Idiopathic Outflow Tract Premature Ventricular Complexes"],"prefix":"10.1001","volume":"10","author":[{"given":"Marco J. W.","family":"G\u00f6tte","sequence":"first","affiliation":[{"name":"Department of Cardiology, Amsterdam University Medical Centers, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luuk H. G. A.","family":"Hopman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam University Medical Centers, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranav","family":"Bhagirath","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam University Medical Centers, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel J. B.","family":"Kemme","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam University Medical Centers, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jules L.","family":"Nelissen","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Lindborg","sequence":"additional","affiliation":[{"name":"Imricor Medical Systems, Burnsville, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel J.","family":"Krafft","sequence":"additional","affiliation":[{"name":"Siemens Healthineers AG, Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke E. S.","family":"Sprengers","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven A. J.","family":"Chamuleau","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam University Medical Centers, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelis P.","family":"Allaart","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam University Medical Centers, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"40","key":"hbr250013r1","doi-asserted-by":"publisher","first-page":"3997","DOI":"10.1093\/eurheartj\/ehac262","article-title":"2022 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death.","volume":"43","author":"Zeppenfeld","year":"2022","journal-title":"Eur Heart J"},{"issue":"8","key":"hbr250013r2","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1016\/j.hroo.2024.07.001","article-title":"Optimizing ventricular tachycardia ablation through imaging-based assessment of arrhythmic substrate: a comprehensive review and roadmap for the future.","volume":"5","author":"Burger","year":"2024","journal-title":"Heart Rhythm O2"},{"issue":"2","key":"hbr250013r3","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.jacep.2016.07.005","article-title":"Development, preclinical validation, and clinical translation of a cardiac magnetic resonance\u2014electrophysiology system with active catheter tracking for ablation of cardiac arrhythmia.","volume":"3","author":"Chubb","year":"2017","journal-title":"JACC Clin Electrophysiol"},{"issue":"2","key":"hbr250013r4","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1093\/ehjci\/jey143","article-title":"Clinical workflow and applicability of electrophysiological cardiovascular magnetic resonance-guided radiofrequency ablation of isthmus-dependent atrial flutter.","volume":"20","author":"Paetsch","year":"2019","journal-title":"Eur Heart J Cardiovasc Imaging"},{"issue":"5","key":"hbr250013r5","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/j.hroo.2022.06.011","article-title":"Magnetic resonance imaging-guided conventional catheter ablation of isthmus-dependent atrial flutter using active catheter imaging.","volume":"3","author":"Ulbrich","year":"2022","journal-title":"Heart Rhythm O2"},{"issue":"4","key":"hbr250013r6","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1093\/ehjci\/jead014","article-title":"A comprehensive view on real-time magnetic resonance-guided flutter ablation image planes from an electrophysiological perspective.","volume":"24","author":"Hopman","year":"2023","journal-title":"Eur Heart J Cardiovasc Imaging"},{"issue":"12","key":"hbr250013r7","doi-asserted-by":"publisher","first-page":"2665","DOI":"10.1016\/j.jacep.2023.08.013","article-title":"Atrial ablation lesion evaluation by cardiac magnetic resonance: review of imaging strategies and histological correlations.","volume":"9","author":"Hopman","year":"2023","journal-title":"JACC Clin Electrophysiol"},{"issue":"6","key":"hbr250013r8","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytae271","article-title":"First experience with a vendor-neutral three-dimensional mapping system for cardiac magnetic resonance-guided electrophysiological procedures: a case report.","volume":"8","author":"De Zan","year":"2024","journal-title":"Eur Heart J Case Rep"},{"issue":"4","key":"hbr250013r9","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.1002\/mrm.28001","article-title":"Acute enhancement of necrotic radio-frequency ablation lesions in left atrium and pulmonary vein ostia in swine model with non-contrast-enhanced T1-weighted MRI.","volume":"83","author":"Guttman","year":"2020","journal-title":"Magn Reson Med"},{"issue":"4","key":"hbr250013r10","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1002\/jmri.25749","article-title":"Real-time MRI guidance of cardiac interventions.","volume":"46","author":"Campbell-Washburn","year":"2017","journal-title":"J Magn Reson Imaging"}],"container-title":["JAMA Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamacardiology\/articlepdf\/2839123\/jamacardiology_gtte_2025_br_250013_1762209245.98091.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T16:01:38Z","timestamp":1762963298000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamacardiology\/fullarticle\/2839123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,1]]},"references-count":10,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamacardio.2025.3000","relation":{},"ISSN":["2380-6583"],"issn-type":[{"value":"2380-6583","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11,1]]}}}