Journal Article

Visualization of the radiofrequency lesion after pulmonary vein isolation using delayed enhancement magnetic resonance imaging fused with magnetic resonance angiography

Toba, Takayoshi, MD, Miyata, Taishi, MD, Yokoi, Kiminobu, MD, Ohishi, Shogo, MD, Kawai, Hiroya, MD, Matsuoka, Yuuki, MD, Taniguchi, Yasuyo, MD, Tsukishiro, Yasue, MD, Teranishi, Jin, MD, Sawada, Takahiro, MD, Yasaka, Yoshinori, MD, Yamada, Shinichiro, MD, Ikeuchi, Kazushi, RT, Okajima, Katsunori, MD, Aoki, Kousuke, MD, Kobayashi, Seiichi, MD, Ikeda, Takayuki, RT, Kiuchi, Kunihiko, MD, Tsubata, Hideo, MD, Onishi, Tetsuari, MD, Shimane, Akira, MD, Chimura, Misato, MD, Shigenaga, Yutaka, RT

2015

Overview

Abstract Background The radiofrequency (RF) lesions for atrial fibrillation (AF) ablation can be visualized by delayed enhancement magnetic resonance imaging (DE-MRI). However, the quality of anatomical information provided by DE-MRI is not adequate due to its spatial resolution. In contrast, magnetic resonance angiography (MRA) provides similar information regarding the left atrium (LA) and pulmonary veins (PVs) as computed tomography angiography. We hypothesized that DE-MRI fused with MRA will compensate for the inadequate image quality provided by DE-MRI. Methods DE-MRI and MRA were performed in 18 patients who underwent AF ablation (age, 60±9 years; LA diameter, 42±6 mm). Two observers independently assessed the DE-MRI and DE-MRI fused with MRA for visualization of the RF lesion (score 0–2; where 0: not visualized and 2: excellent in all 14 segments of the circular RF lesion). Results DE-MRI fused with MRA was successfully performed in all patients. The image quality score was significantly higher in DE-MRI fused with MRA compared to DE-MRI alone (observer 1: 22 (18, 25) vs 28 (28, 28), p <0.001; observer 2: 24 (23, 25) vs 28 (28, 28), p <0.001). Conclusions DE-MRI fused with MRA was superior to DE-MRI for visualization of the RF lesion owing to the precise information on LA and PV anatomy provided by DE-MRI.

• Publisher: John Wiley & Sons, Inc,Japanese Heart Rhythm Society,Wiley
• Subject: Ablation / Ablation (Surgery) / Angiography / Atrial fibrillation / Cardiac arrhythmia / Cardiovascular / Cardioversion / Catheter ablation / Catheters / CT imaging / delayed enhancement magnetic resonance imaging / Delayed enhancement MRI / DE‐MRI / Electrodes / Esophagus / Heart rate / left atrium / magnetic resonance angiography / Magnetic resonance imaging / Medical imaging / MRA / Original / Patients / pulmonary vein / radiofrequency / Radiofrequency lesions / Respiration / Software / Tomography / Veins & arteries / Visualization