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Final Program


Program-At-A-Glance

Oral Abstracts Session

Session: Oral Abstracts Translation Session 1

Epicardial Surface Potential Recording during MR-guided RF ablation in an MR-Compatible Isolated Beating Pig Heart Platform

Thursday, February 5, 2026
3:00 PM - 3:10 PM  
Location: Oceania IV and V (2nd Floor)
Background: Interventional Cardiac Magnetic Resonance (iCMR) is an emerging application of MRI requiring substantial technical development. A challenge remains in acquiring and characterizing electrocardiographic (ECG) signals in the MRI environment, as clinically important interventions such as radiofrequency (RF) ablation alter tissue properties relevant to electrical conduction. An innovative MR-compatible isolated beating pig heart platform (PhysioHeartTM, LifeTec Group B.V., Eindhoven, The Netherlands) provides a semi-realistic physiological setup for testing new technologies under controlled conditions. Using this platform, direct measurements of surface potentials during MRI-guided ablation offer the opportunity to directly link acute tissue modification to altered electrical activation and give new pathological insights, useful for improving iCMR strategies. Building on this rationale, we conducted a proof-of-concept study to evaluate the feasibility of recording multi-lead epicardial surface potentials during MR-guided RF ablation on this MRI-compatible pig heart platform and integrating these signals into 3D activation models.

Methods: Two pig hearts were harvested and prepared as described by Peper et al. [1] and connected to the platform positioned in a 3T MRI scanner (MR7700, Philips, Best, The Netherlands) for RF ablation (Advantage, Imricor, Burnsville, MN, USA). Epicardial ECGs were acquired using an MR-compatible 12-lead ECG system (PELEX-MAX, PinMed, Pittsburgh, USA). Signals were processed using a customized, in-house-developed Python pipeline (V3.11) and mapped onto personalized bi-ventricular meshes (Fig. 1, bottom left) to visualize 3D activation and estimate cardiac conduction velocity (CV) using the inverse of the local activation time gradient.

Results: Pre-ablation, activation patterns were stable (Fig. 2, blue) with physiologically normal CVs (~600 mm/s in the anterior LV, Fig. 3), consistent with prior ultra-high-density catheter mapping in pigs [2]. Both hearts developed ventricular fibrillation requiring successful defibrillation and anti-arrhythmic therapy during catheter manipulation and/or ablation. Post-ablation, QRS complexes shortened with morphological changes, likely reflecting anti-arrhythmic effects and ischemia (Fig. 2, orange). Spatial mapping showed minimal overall changes in local activation times, dispersion, and CV, with only localized conduction slowing near ablation sites (Figs. 1 and 3).

Conclusion: This proof-of-concept study provides preliminary evidence that epicardial ECG signals can be acquired and analyzed during MRI-guided RF ablation using an MRI-compatible isolated beating pig heart platform. Integration of ECG with spatial mapping allowed visualization of activation and CV, supporting the physiological feasibility of the approach. Despite the small sample size and procedural confounders, this approach may provide a framework for future validation and for further development of real-time MR-guided electrophysiological interventions.

Integration of personalized cardiac models with the experimental setup. (Top panel) Personalized 3D segmentation of the heart with annotated ablation points (red spheres, numbered 1–6) shown from anterior (left) and short-axis view (middle), with the ablation points adopted from the post-ablation T1 scan (right). (Bottom panel) a personalized, 3D heart mesh (left) with annotated precordial lead positions (V2–V6, blue markers) and a generic coronary vessel anatomy, the pig heart with the leads for the epicardial potential recordings (middle), and the MR-compatible pig heart platform inside the MRI environment (right).
ECG signal pre- and post-ablation aligned around the R-peak. ECG (in V) signal pre- and post-ablation aligned around the R-peak for 4 beats. In leads V1 and V2, the initial activation occurs slightly earlier before ablation (blue), with a delayed upstroke and lower amplitude post-ablation (orange), suggesting a shift in earliest activation away from these regions. V3-V6 show relatively preserved QRS morphology, but with reduced amplitude and slight delay in the ascending limb of the QRS complex post-ablation. The amplitude of R-waves appears to be reduced in V4-V6, consistent with ablation-induced changes in local depolarization. Overall, shortening of the QRS complex duration is evident post-ablation, especially in V5-V6.
3D conduction velocity estimation maps for pre- and post-ablation and the difference between pre- and post-ablation. Conduction velocity (CV) estimates based on activation gradient before (Fig. 3A), and after (Fig. 3B) ablation, and the difference between the two (Fig. 3C-D). Purple and blue represent relative slow CV estimation, whereas green and yellow represent relative fast CV estimation. The difference in CV per triangle inside the mesh is shown in Figures 3C-D. A positive value indicates increased velocity, whereas a negative value shows decreased estimated CV post ablation.