期刊
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
卷 24, 期 4, 页码 396-403出版社
WILEY
DOI: 10.1111/jce.12063
关键词
atrial fibrillation; catheter ablation; cryoablation; late gadolinium enhancement; MRI; pulmonary vein isolation
资金
- British Heart Foundation [RG/10/11/28457]
- National Institute for Health Research
- British Heart Foundation [RG/10/11/28457, PG/10/37/28347] Funding Source: researchfish
MRI Detection of Left Atrial Ablation Lesions.Introduction: We tested the hypothesis that cardiovascular magnetic resonance (CMR) imaging can reliably distinguish the presence or absence of left atrial (LA) ablation lesions by blinded analysis of pre- and postablation imaging. Methods: Consecutive patients at 2 centers undergoing pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation by either wide area circumferential radiofrequency ablation (WACA) or ostial ablation with a cryoballoon underwent CMR late gadolinium enhancement (LGE) imaging pre- and 3 months postablation. Imaging was anonymized for blinded analysis of (1) LGE images, and (2) a 3D fusion image with LGE projected onto a segmented LA surface. Scans were categorized using both assessment techniques separately as pre- or postablation, and if postablation, whether lesions were in an ostial or WACA distribution. Results: LGE imaging was performed in 50 patients (aged 60 +/- 10 years, 68% male, 24 underwent WACA and 26 had cryoablation). Sensitivity and specificity for detection of ablation lesions was 60% and 96% on LGE imaging. Sensitivity was higher using 3D fusion imaging (88%; P = 0.003). The proportion in whom lesions were both detected and the distribution correctly assessed as WACA or ostial was higher with 3D fusion imaging compared to LGE imaging (54% vs 28%; P = 0.014). There was no difference in the detection of radiofrequency ablation lesions compared to cryoablation lesions (58% vs 62%; P = 1.000). Conclusion: LGE imaging of atrial scar is not yet sufficiently accurate to reliably identify ablation lesions or to determine lesion distribution. (J Cardiovasc Electrophysiol, Vol. 24, pp. 396-403, April 2013)
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