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When we first opened Imricor Medical’s website and turned to the About Us page, this is what we read:
Imricor Medical Systems, Inc. (ASX:IMR) is a leading developer of innovative MRI-compatible medical devices which can be used to carry out MRI-guided cardiac catheter ablation procedures.
It was at that moment we released this company is going to need a little explaining.
Let’s start by explaining irregular heartbeats
According to the Cleveland Clinic in the United States, between 1.5% and 5% of people have irregular heartbeats (known as arrhythmias). Heart arrhythmias may feel like a fluttering or racing heart and in many cases are harmless. However, there are times when heart arrhythmias can become a problem, and sometimes even life threatening.
There are two types of heart arrhythmias, divided by the speed of the heart rate.
- Tachycardia is the term for ‘fast hearts’. The resting heart rate is greater than 100 beats a minute.
- Bradycardia is the term for ‘slow hearts’. The resting heart rate is less than 60 beats per minute.
These heart arrhythmias occur when the electrical signals that coordinate the heart’s beat don’t work properly.
How do you solve an electrical problem with the heart?
Heart arrhythmia treatment is only needed if the irregular heartbeat is causing significant health challenges or the condition is creating the risk of more serious heart problems. Where treatment is required, there are a variety of options: medication, therapies, catheter procedures or heart surgery.
One of the catheter procedures doctors have at their disposal is a catheter ablation.
In this procedure, the doctor threads one or more catheters through the blood vessels to the heart. Electrodes at the catheter tips use heat or cold energy to create tiny scars in your heart to block abnormal electrical signals and restore a normal heartbeat.
Mayo Clinic
When doctors perform cardiac catheter ablation, they need to see where the patient’s heart and where the catheter is going. The current state of the art is x-ray fluoroscopy. Simply, if your traditional x-ray is a picture then x-ray fluoroscopy is a movie. X-ray fluoroscopy displays a continuous x-ray image on a monitor, allowing doctors to monitor in real time how they are moving the catheter through the patient’s body.
Using the imaging of an x-ray fluoroscopy, doctors then run thin wire electrodes to the heart and use them to measure the heart’s electrical signals and are used to stimulate the heart and attempt to correct the abnormal rhythm (the arrhythmia).
Using the imaging of an x-ray fluoroscopy, doctors then run thin wire electrodes to the heart and use them to measure the heart’s electrical signals and are used to stimulate the heart and attempt to correct the abnormal rhythm (the arrhythmia).
Source: Mayo Foundation
If none of the above made sense, this explainer video is the best we’ve found for the non-medical reader (i.e. us):
That is the current state of cardiac catheter ablation. Imricor Medical Systems believe there is a better way.
Imricor believe that MRI > X-ray
Imricor is pioneering a new way for doctors to conduct the cardiac catheter ablation. Rather than using an x-ray to image the patient and guide the catheter to the patient’s heart, Imricor believes MRI machines are a better option. As such, it is developing MRI-compatible medical devices to carry out cardiac ablation procedures.
They believe that using continuous real-time 3D MRI guidance rather than x-ray fluoroscopy offers:
- Better first-time results
- Faster and safer procedures
- Lower cost
- An environment free from radiation exposure
According to John Hopkins Medical Centre, cardiac catheter ablation can take between two and four hours to complete. Using x-ray fluoroscopy has patients and doctors exposed to radiation from the x-ray for that whole time. MRI does not emit radiation (which is why it is already the imaging modality of choice when a patient requires frequent imaging – because you don’t want regular exposure to x-ray radiation). So Imricor have been focused on developing an MRI alternative for this procedure.
That’s not even the biggest advantage that Imricor sees. It is the detailed imaging and the better patient outcomes that unlocks that Imricor believes will be their difference maker. When a cardiologist is ablating (which remember is burning different parts of a patient’s heart) a big challenge is knowing whether the burn is permanent or temporary (because temporary burns heal and then the irregular heartbeat returns). If the burn is only temporary, often patients will need to re-do the procedure again. MRI’s offer far more detailed images of the heart than x-ray and as such give doctors a far more accurate look at whether the burn was permanent. For Imricor, they hope to help hospitals improve success rates and reduce the need to re-do procedures.
Where is Imricor on their journey?
Today, Imricor has regulatory approval to treat atrial flutter in Europe. In the first half of 2023, 44 cardiac catheter ablation procedures were performed using their MRI-based technology in Europe.
They are working to expand their regulatory approval in Europe to other arrhythmias while at the same time working through regulatory approval processes in the United States, Australia, New Zealand and the Middle East.
In Europe, Imricor has approval to start a clinical trial for ventricular tachycardia ablations. In the United States, they have approval to commence a worldwide clinical trial starting with atrial flutter to support US FDA approval.
The challenges Imricor face
There is no doubt that MRI’s can create far more detailed images of the heart than x-ray and in doing so, give doctors a far more accurate look at what is happening during an ablation procedure. But with that accuracy comes additional cost. MRI’s are more expensive than x-rays and given ablation procedures can last hours, Imricor will have to convince doctors and healthcare systems that the additional expense will be worth it in driving better patient outcomes.
Imricor has a response to this challenge, they want to take up existing MRI’s. The company has a saying, “We are not bringing ablations into the MRI, we are bringing MRI to ablations”. What they mean by that is by replacing an Xray fluoroscopy lab with an iCMR lab you can do your ablation procedures plus have an additional MRI that can be used for other imaging when procedures are not being performed.
Ultimately, co-founder and CEO of Imricor, Steve Wedan, believes that MRI is a better imaging choice than Xray and that is all that will matter in the long run. He hopes his company can help accelerate this change.
We plan to expand to any medical intervention where a doctor could do a better job for their patients if they could see, in real-time, the soft tissue they are addressing during a procedure. I believe people will look back in the future and say “yes, of course we do interventions guided by MRI, and of course that’s where it was always destined to go. It’s so obvious.”