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This position paper discusses the current developments and advances of electrophysiological (EP) interventions guided by magnetic resonance imaging (MRI) and the associated technological challenges and difficulties which need to be overcome in the future. MRI provides several advantages compared to other medical imaging modalities. However, performing any kind of intervention or surgery in an MRI scanner is technical challenging. EP procedures are a special case since they involve many sensitive electronic stimulation and measurement devices and also require a high quality patient monitoring. Monitoring the patient’s electrocardiogram (ECG) inside an MRI is a challenging task due to the MRI’s hazardous environment. Hence, ECG signals are highly distorted and are of limited diagnostic value. This limitation in ECG-based patient monitoring and the lack of a fully functional, MRI-conditional 12-lead ECG hampers or delays the progress of EP procedures during MRI. We review and discuss the main reasons for this limitation and give an outlook and recommendation for further research approaches.

Progress of MRI-guided EP Interventions is Hampered by a Lack of ECG-based Patient Monitoring – An Engineering Perspective