Stephenson Cardiac Imaging Centre recruits innovator

Long before Dr. Marco Götte, MD, PhD, became a leading expert in cardiac MRI, he was a teenager in central Netherlands, captivated by a documentary on heart transplantation. That moment sparked a lifelong pursuit — one that’s now brought him to Calgary as the new scientific director of the Stephenson Cardiac Imaging Centre. 

Götte’s early fascination with the heart led him to pursue medicine at Erasmus University in Rotterdam, home to one of the largest heart centres in the Netherlands and the largest port in Europe.  

“I became a doctor because I wanted to become a cardiologist,” says Götte. “I was the first in my family to pursue medicine, and I chose my medical school because Rotterdam had the biggest heart centre in the Netherlands at that time.”  

Following medical school, Götte continued his studies at the VUmc-Amsterdam, now Amsterdam UMC, completing his training specializing in cardiology and a PhD in cardiac remodelling evaluated by MRI. During this time, he was inspired by the work of his mentor Dr. Albert van Rossum, a prominent figure in cardiac MRI whom Götte describes as The Netherland’s “grandfather of cardiac MRI.”   

During this time, Götte gained a strong passion for cardiac MR imaging, ultimately pursuing a career as a clinician and researcher in the field.  

“It’s the cardiac mechanics and MRI’s technology itself that attract me,” says Götte, who served for almost a decade as chief trainer of cardiology and director of the cardiac MRI service at Haga Teaching Hospital in The Hague. “Cardiac MRI offers you the possibility to see the heart contracting and deforming, to characterize tissue or changes in tissue, to quantify the blood flow and to assess the valves. Being able to visualize in vivo the heart working is amazing.”  

Götte has a particular interest in MRI-guided cardiac interventions. His research activities eventually brought him back to Amsterdam UMC, where, in addition to his regular academic clinical activities, he was able to further shape and expand his pioneering work in interventional MRI. 

This work involves using MRI technology—normally used for diagnostic purposes—to guide interventions, such as cardiac ablations, a procedure that intentionally creates scars on the heart tissue to treat/cure patients from arrhythmias.  

Cardiac ablations are performed via catheters and are traditionally guided by X-ray fluoroscopy.  

Götte explains because soft tissue is not visible using X-ray technology, physicians rely on electrical signals to help guide them to the area of the heart that needs ablation. This limits accuracy and can result in the need for re-ablation procedures.  

“In contrast, MRI offers in detail the soft tissue of the heart while it’s beating, allowing more accuracy in maneuvering catheters within the contracting heart and in the visualization of the changes being made during the procedure,” says Götte. 

“With this technique, we potentially can reduce procedural time and the number of re-ablations, allowing us to treat more patients and reduce wait times. Unlike traditional fluoroscopy, no harmful X-ray radiation is required to visualize the catheters, which improves safety not only for patients, but also for the medical staff helping patients requiring a cardiac intervention. “No more lead aprons are required.”

Building a new, multi-disciplinary team capable of doing interventions in an MRI-environment—using a new imaging technique—wasn’t easy. 

This clinical and cutting-edge technical research required collaboration between clinicians, including imaging cardiologists, cardiac electrophysiologists, MRI technologists, and engineers and technicians —individuals not used to working together in one dedicated team.    

“When an electrophysiologist was introduced to this technology, his first reaction was ‘nice, someone turned the lights on,’” says Götte, adding the medical team also had to learn to communicate in what was an unfamiliar clinical setting for all team members, each with a different background and typical language specific for their field of expertise.  

The team flourished. 

Recently, it was the first in the world to complete an MRI-guided left ventricular ablation. The unprecedented procedure, which Götte says is risky because of the potential to introduce life-threatening arrhythmias, was successful. The team was able to terminate the ventricular arrhythmia and the patient was cured. 

Part of Götte’s work involves developing devices compatible with MRI technology to facilitate these clinical innovations. 

According to Götte, it’s a technical challenge to develop equipment normally found in traditional X-ray -based catheterization labs, such as catheters and other instruments, ECG-recording systems, defibrillators and monitors, that can be used in proximity to the MRI scanner, which is basically a very strong magnet.   

Other areas of his research include improving MR image analysis, evaluating interventions and developing artificial intelligence models.  

One tool Götte helped to develop was an MRI-compatible, explanted beating-pig heart platform. This platform helps researchers improve MR imaging strategies, allows the visualization of the heart’s response to interventions in real time and may serve as a training tool to prepare for new types of MRI-guided interventions   

Götte officially began his new Calgary role on Aug. 1. He’s excited to take on a new challenge. 

“Calgary’s long-standing expertise in advanced cardiac MRI and its strong tradition of multidisciplinary collaboration, creates an ideal setting for pioneering research,” says Götte. 

“This fits seamlessly with the University of Calgary’s broader ambition to continue to grow as a leading health tech hub, where a dynamic and supportive ecosystem drives the development, testing and clinical integration of new technologies to improve patient care. We are opening up a new era in cardiac MRI.”