Cardiac magnetic resonance for early atrial lesion visualization post atrial fibrillation radiofrequency catheter ablation.

Autor: Guglielmo M; Department of Cardiology, Division of Heart and Lungs, Utrecht University Medical Center, Utrecht University, Utrecht, The Netherlands.; Department of Cardiology, Haga Teaching Hospital, The Hague, The Netherlands., Rier S; Department of Cardiology, Haga Teaching Hospital, The Hague, The Netherlands., Zan G; Department of Cardiology, Division of Heart and Lungs, Utrecht University Medical Center, Utrecht University, Utrecht, The Netherlands.; Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy., Krafft AJ; Siemens Healthcare GmbH, Erlangen, Germany., Schmidt M; Siemens Healthcare GmbH, Erlangen, Germany., Kunze KP; MR Research Collaborations, Siemens Healthcare Limited, Camberley, UK.; King's College London, London, UK., Botnar RM; MR Research Collaborations, Siemens Healthcare Limited, Camberley, UK.; King's College London, London, UK., Prieto C; MR Research Collaborations, Siemens Healthcare Limited, Camberley, UK.; King's College London, London, UK., van der Heijden J; Department of Cardiology, Haga Teaching Hospital, The Hague, The Netherlands., Van Driel V; Department of Cardiology, Haga Teaching Hospital, The Hague, The Netherlands., Ramanna H; Department of Cardiology, Haga Teaching Hospital, The Hague, The Netherlands., van der Harst P; Department of Cardiology, Division of Heart and Lungs, Utrecht University Medical Center, Utrecht University, Utrecht, The Netherlands., van der Bilt I; Department of Cardiology, Division of Heart and Lungs, Utrecht University Medical Center, Utrecht University, Utrecht, The Netherlands.; Department of Cardiology, Haga Teaching Hospital, The Hague, The Netherlands.
Jazyk: angličtina
Zdroj: Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2024 Feb; Vol. 35 (2), pp. 258-266. Date of Electronic Publication: 2023 Dec 08.
DOI: 10.1111/jce.16152
Abstrakt: Background: Incomplete atrial lesions resulting in pulmonary vein-left atrium reconnection after pulmonary vein antrum isolation (PVAI), are related to atrial fibrillation (AF) recurrence. Unfortunately, during the PVAI procedure, fluoroscopy and electroanatomic mapping cannot accurately determine the location and size of the ablation lesions in the atrial wall and this can result in incomplete PVAI lesions (PVAI-L) after radiofrequency catheter ablation (RFCA).
Aim: We seek to evaluate whether cardiac magnetic resonance (CMR), immediately after RFCA of AF, can identify PVAI-L by characterizing the left atrial tissue.
Methods: Ten patients (63.1 ± 5.7 years old, 80% male) receiving a RFCA for paroxysmal AF underwent a CMR before (<1 week) and after (<1 h) the PVAI. Two-dimensional dark-blood T2-weighted short tau inversion recovery (DB-STIR), Three-dimensional inversion-recovery prepared long inversion time (3D-TWILITE) and three-dimensional late gadolinium enhancement (3D-LGE) images were performed to visualize PVAI-L.
Results: The PVAI-L was visible in 10 patients (100%) using 3D-TWILITE and 3D-LGE. Conversely, On DB-STIR, the ablation core of the PAVI-L could not be identified because of a diffuse high signal of the atrial wall post-PVAI. Microvascular obstruction was identified in 7 (70%) patients using 3D-LGE.
Conclusion: CMR can visualize PVAI-L immediately after the RFCA of AF even without the use of contrast agents. Future studies are needed to understand if the use of CMR for PVAI-L detection after RFCA can improve the results of ablation procedures.
(© 2023 Wiley Periodicals LLC.)
Databáze: MEDLINE