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Nonenhanced magnetic resonance imaging for characterization of acute and subacute radiofrequency ablation lesions

2006; Elsevier BV; Volume: 4; Issue: 2 Linguagem: Inglês

10.1016/j.hrthm.2006.11.013

1556-3871

Ehud J. Schmidt, Vivek Y. Reddy, Jeremy N. Ruskin,

Atrial Fibrillation Management and Outcomes

The utilization of computed tomography (CT) and magnetic resonance imaging (MRI) in the electrophysiology laboratory is increasing steadily. 1 De Buck S. Maes F. Ector J. Bogaert J. Dymarkowski S. Heidbuchel H. Suetens P. An augmented reality system for patient-specific guidance of cardiac catheter ablation procedures. IEEE Trans Med Imaging. 2005; 24: 1512-1524 Crossref PubMed Scopus (66) Google Scholar , 2 Dickfeld T. Calkins H. Zviman M. Meininger G. Lickfett L. Roguin A. Lardo A.C. Berger R. Halperin H. Solomon S.B. Stereotactic magnetic resonance guidance for anatomically targeted ablations of the fossa ovalis and the left atrium. J Interv Card Electrophysiol. 2004; 11: 105-115 Crossref PubMed Scopus (34) Google Scholar , 3 Reddy V.Y. Malchano Z.J. Holmvang G. Schmidt E.J. d'Avila A. Houghtaling C. Chan R.C. Ruskin J.N. Integration of cardiac magnetic resonance imaging with three-dimensional electroanatomic mapping to guide left ventricular catheter manipulation: feasibility in a porcine model of healed myocardial infarction. J Am Coll Cardiol. 2004; 44: 2202-2213 Abstract Full Text Full Text PDF PubMed Scopus (147) Google Scholar Current clinical use of these images consists of preprocedural planning of catheter ablation procedures for treatment of ventricular tachycardia and atrial fibrillation utilizing three-dimensional reconstructions to provide the geometry and sizes of cardiac structures. The reconstructions are integrated with electroanatomic systems to provide anatomically accurate road maps to guide catheter manipulation. A future phase may use postprocedural CT or MRI to assess the long-term success of an ablation procedure through quantification of the size and location of the ablation lesions and possibly through quantification of changes in cardiovascular function resulting from the procedure. A yet longer-term phase may involve using MRI or CT imaging during the ablation process, providing feedback to the clinician on the locations and quality of the lesions created in real time. The study by Dickfeld et al 4 Dickfeld T. Kato R. Zviman M. Nazarian S. Dong J. Ashikaga H. Lardo A.C. Berger R.D. Calkins H. Halperin H. Characterization of acute and subacute radiofrequency ablation lesions with nonenhanced magnetic resonance imaging. Heart Rhythm. 2007; 4 (208–214) Abstract Full Text Full Text PDF PubMed Scopus (86) Google Scholar in the current issue of Heart Rhythm is intended to enable the utilization of MRI for follow-up. The study also provides valuable data that would be necessary for proper utilization of intraprocedural MRI.