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Figure 6 MRI-guided catheter navigation in vivo to the myocardial infarct borders. (A) The porcine infarct models underwent MRI  4 months after the anterior wall infarction procedure. The gadolinium-enhanced scarred myocardium (yellow arrows) is shown in these long- and short-axis (inset) delayed enhancement magnetic resonance images. (B) The aorta, LV endocardium, and myocardial scars were manually segmented and compiled into 3D datasets. During MEAM, the chamber geometries were constructed without displaying the corresponding electrophysiologic information. Radiofrequency ablation lesions were subsequently targeted to the borders of the scar solely on the basis of the registered MR image. Shown are the re-compiled surface reconstructions of the segmented LV, aorta, and scarred myocardium (in brown). (C) The registered 3D MRI of the porcine infarct model is shown: orange dots = LV points; blue dots = aorta points. (D) The electroanatomic bipolar voltage map depicts the anterior wall myocardial infarct; the color range was set such that the purple color represents normal tissue (i.e., >1.5 mV). The ablation lesions are shown as red dots; the yellow arrow denotes the ablation corresponding to the catheter position shown as a green icon in (E). (F) The corresponding ablation lesion (blue asterisk) was noted upon gross pathologic examination to be situated at the scar border; two other ablation lesions placed near the LV apex (yellow asterisk) were also appropriately localized to the scar borders. Abbreviations as in Figure 1.
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