Cardiac magnetic resonance and electroanatomical mapping of acute and chronic atrial ablation injury: a histological validation study.

Autor:	Harrison JL; Division of Imaging Sciences & Biomedical Engineering, Medical Engineering Centre, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, SE1 7EH London, UK Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK james.harrison@kcl.ac.uk., Jensen HK; Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark., Peel SA; Division of Imaging Sciences & Biomedical Engineering, Medical Engineering Centre, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, SE1 7EH London, UK., Chiribiri A; Division of Imaging Sciences & Biomedical Engineering, Medical Engineering Centre, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, SE1 7EH London, UK Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK., Grøndal AK; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital Skejby, Aarhus, Denmark MR-Center, Aarhus University Hospital Skejby, Aarhus, Denmark., Bloch LØ; Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark MR-Center, Aarhus University Hospital Skejby, Aarhus, Denmark., Pedersen SF; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital Skejby, Aarhus, Denmark., Bentzon JF; Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark Department of Clinical Medicine, Aarhus University, Aarhus, Denmark., Kolbitsch C; Division of Imaging Sciences & Biomedical Engineering, Medical Engineering Centre, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, SE1 7EH London, UK., Karim R; Division of Imaging Sciences & Biomedical Engineering, Medical Engineering Centre, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, SE1 7EH London, UK., Williams SE; Division of Imaging Sciences & Biomedical Engineering, Medical Engineering Centre, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, SE1 7EH London, UK Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK., Linton NW; Division of Imaging Sciences & Biomedical Engineering, Medical Engineering Centre, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, SE1 7EH London, UK Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK., Rhode KS; Division of Imaging Sciences & Biomedical Engineering, Medical Engineering Centre, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, SE1 7EH London, UK., Gill J; Division of Imaging Sciences & Biomedical Engineering, Medical Engineering Centre, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, SE1 7EH London, UK Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK., Cooklin M; Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK., Rinaldi CA; Division of Imaging Sciences & Biomedical Engineering, Medical Engineering Centre, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, SE1 7EH London, UK Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK., Wright M; Division of Imaging Sciences & Biomedical Engineering, Medical Engineering Centre, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, SE1 7EH London, UK Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK., Kim WY; Department of Cardiology, Aarhus University Hospital Skejby, Aarhus, Denmark MR-Center, Aarhus University Hospital Skejby, Aarhus, Denmark., Schaeffter T; Division of Imaging Sciences & Biomedical Engineering, Medical Engineering Centre, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, SE1 7EH London, UK., Razavi RS; Division of Imaging Sciences & Biomedical Engineering, Medical Engineering Centre, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, SE1 7EH London, UK., O'Neill MD; Division of Imaging Sciences & Biomedical Engineering, Medical Engineering Centre, King's College London, 3rd Floor, Lambeth Wing, St Thomas' Hospital, SE1 7EH London, UK Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
Jazyk:	angličtina
Zdroj:	European heart journal [Eur Heart J] 2014 Jun 07; Vol. 35 (22), pp. 1486-95. Date of Electronic Publication: 2014 Jan 12.
DOI:	10.1093/eurheartj/eht560
Abstrakt:	Aims: To provide a comprehensive histopathological validation of cardiac magnetic resonance (CMR) and endocardial voltage mapping of acute and chronic atrial ablation injury. Methods and Results: 16 pigs underwent pre-ablation T2-weighted (T2W) and late gadolinium enhancement (LGE) CMR and high-density voltage mapping of the right atrium (RA) and both were repeated after intercaval linear radiofrequency ablation. Eight pigs were sacrificed following the procedure for pathological examination. A further eight pigs were recovered for 8 weeks, before chronic CMR, repeat RA voltage mapping and pathological examination. Signal intensity (SI) thresholds from 0 to 15 SD above a reference SI were used to segment the RA in CMR images and segmentations compared with real lesion volumes. The SI thresholds that best approximated histological volumes were 2.3 SD for LGE post-ablation, 14.5 SD for T2W post-ablation and 3.3 SD for LGE chronically. T2-weighted chronically always underestimated lesion volume. Acute histology showed transmural injury with coagulative necrosis. Chronic histology showed transmural fibrous scar. The mean voltage at the centre of the ablation line was 3.3 mV pre-ablation, 0.6 mV immediately post-ablation, and 0.3 mV chronically. Conclusion: This study presents the first histopathological validation of CMR and endocardial voltage mapping to define acute and chronic atrial ablation injury, including SI thresholds that best match histological lesion volumes. An understanding of these thresholds may allow a more informed assessment of the underlying atrial substrate immediately after ablation and before repeat catheter ablation for atrial arrhythmias. (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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