title: Role of magnetic resonance imaging in atrial fibrillation ablation.
abstract: Ablation therapy is widely used for treatment of drug-resistant atrial fibrillation (AF). Ablation success for AF, however, is relatively low, often requiring repeated procedures for long-term suppression of the arrhythmia. Utilization of imaging techniques that visualize cardiac anatomy, function, and tissue characteristics may improve ablation results. Compared to other imaging modalities, cardiac magnetic resonance (CMR) has several advantages, including the lack of ionizing radiation and unsurpassed soft tissue resolution. Chamber morphology images can be registered onto electroanatomic maps acquired during the procedure, thus improving procedural safety and efficacy. In addition, the ability of CMR to characterize myocardial tissues may optimize patient selection for ablation and thromboembolic risk stratification. Post-procedure CMR can be used to detect potential complications, and with improved resolution, it has the potential to assess the integrity of ablation lesions. In this paper we will review the role of CMR in the pre-ablation diagnostic workup of AF patients as well as during and after catheter ablation.
authors.affiliation: Department of Medicine/Cardiology, Johns Hopkins University, 702 Rutland Avenue, Traylor 903, Baltimore, MD, 21287, USA, rbeiner1@jhmi.edu.
authors.forename: Roy
authors.initials: R
authors.lastname: Beinart
authors.forename: Saman
authors.initials: S
authors.lastname: Nazarian
references.citation: CMAJ. 2006 Oct 10;175(8):911-7
references.pmid: 17030942
references.citation: Heart Rhythm. 2008 May;5(5):656-62
references.pmid: 18452866
references.citation: Circ Arrhythm Electrophysiol. 2009 Aug;2(4):349-61
references.pmid: 19808490
references.citation: J Am Coll Cardiol. 2012 Aug 7;60(6):531-8
references.pmid: 22858289
references.citation: Europace. 2009 Aug;11(8):1004-10
references.pmid: 19541681
references.citation: Circulation. 1997 Sep 2;96(5):1675-85
references.pmid: 9315564
references.citation: J Am Coll Cardiol. 2011 Jul 5;58(2):177-85
references.pmid: 21718914
references.citation: JACC Cardiovasc Imaging. 2009 Mar;2(3):308-16
references.pmid: 19356576
references.citation: Circulation. 2003 Apr 22;107(15):2004-10
references.pmid: 12681994
references.citation: Radiology. 1994 Apr;191(1):137-42
references.pmid: 8134560
references.citation: Heart Rhythm. 2010 Oct;7(10):1475-81
references.pmid: 20601148
references.citation: J Cardiovasc Magn Reson. 2005;7(2):465-73
references.pmid: 15881530
references.citation: J Cardiovasc Electrophysiol. 2011 Jan;22(1):10-5
references.pmid: 20662984
references.citation: Hum Pathol. 2008 Aug;39(8):1162-71
references.pmid: 18440590
references.citation: Heart Rhythm. 2012 Apr;9(4):632-696.e21
references.pmid: 22386883
references.citation: J Cardiovasc Electrophysiol. 2005 Jan;16(1):7-12
references.pmid: 15673379
references.citation: Ann Med. 2007;39(5):371-91
references.pmid: 17701479
references.citation: Hum Pathol. 2005 Oct;36(10):1080-9
references.pmid: 16226107
references.citation: Eur Heart J. 2003 May;24(10):963-9
references.pmid: 12714028
references.citation: AJR Am J Roentgenol. 2006 Jan;186(1):198-205
references.pmid: 16357402
references.citation: Circulation. 1996 Dec 1;94(11):2953-60
references.pmid: 8941126
references.citation: J Cardiovasc Electrophysiol. 2010 Feb;21(2):126-32
references.pmid: 19804549
references.citation: Circulation. 2001 Feb 6;103(5):769-77
references.pmid: 11156892
references.citation: J Cardiovasc Electrophysiol. 2011 Jan;22(1):1-7
references.pmid: 20662985
references.citation: J Am Coll Cardiol. 2011 Feb 15;57(7):831-8
references.pmid: 21310320
references.citation: Cardiovasc Res. 2000 Jun;46(3):476-86
references.pmid: 10912458
references.citation: J Am Coll Cardiol. 2008 Oct 7;52(15):1263-71
references.pmid: 18926331
references.citation: Pacing Clin Electrophysiol. 2007 Oct;30(10):1215-23
references.pmid: 17897124
references.citation: Echocardiography. 2006 Feb;23(2):127-32
references.pmid: 16445730
references.citation: Am J Cardiol. 2006 Apr 15;97(8):1213-9
references.pmid: 16616028
references.citation: Cardiovasc Pathol. 2000 Jan-Feb;9(1):17-28
references.pmid: 10739903
references.citation: Europace. 2011 Mar;13(3):371-5
references.pmid: 21186231
references.citation: Am Heart J. 2000 Apr;139(4):684-9
references.pmid: 10740152
references.citation: J Interv Card Electrophysiol. 2012 Aug;34(2):181-8
references.pmid: 22228410
references.citation: Heart Rhythm. 2013 Sep;10(9):1325-31
references.pmid: 23643513
references.citation: Heart Rhythm. 2013 Dec;10(12):1843-9
references.pmid: 24076444
references.citation: J Am Coll Cardiol. 2011 Apr 26;57(17):1745-51
references.pmid: 21511110
references.citation: J Am Coll Cardiol. 1999 Nov 1;34(5):1577-86
references.pmid: 10551709
references.citation: J Am Soc Echocardiogr. 1999 Dec;12(12):1080-7
references.pmid: 10588784
references.citation: JAMA. 2001 May 9;285(18):2370-5
references.pmid: 11343485
references.citation: Heart Rhythm. 2014 Jan;11(1):85-92
references.pmid: 24096166
references.citation: Echocardiography. 2008 Sep;25(8):918-24
references.pmid: 18986422
references.citation: Circulation. 2009 Apr 7;119(13):1758-67
references.pmid: 19307477
references.citation: J Interv Card Electrophysiol. 2009 Nov;26(2):109-17
references.pmid: 19629666
references.citation: Circulation. 2008 Jul 15;118(3):223-9
references.pmid: 18574048
references.citation: J Cardiovasc Electrophysiol. 2001 Jul;12(7):809-13
references.pmid: 11469433
references.citation: Radiology. 2007 Jun;243(3):690-5
references.pmid: 17517928
references.citation: Ann Intern Med. 2003 Apr 15;138(8):634-8
references.pmid: 12693885
references.citation: Circulation. 1998 Nov 17;98(20):2202-9
references.pmid: 9815876
references.citation: Heart. 2001 Oct;86(4):448-55
references.pmid: 11559688
references.citation: Chest. 2010 Feb;137(2):263-72
references.pmid: 19762550
references.citation: Circulation. 2003 Feb 18;107(6):845-50
references.pmid: 12591754
references.citation: J Cardiovasc Magn Reson. 2002;4(4):443-57
references.pmid: 12549232
references.citation: J Cardiovasc Magn Reson. 2004;6(4):927-36
references.pmid: 15646896
references.citation: Thromb Haemost. 2012 Jun;107(6):1172-9
references.pmid: 22473219
references.citation: Europace. 2010 Aug;12(8):1098-104
references.pmid: 20400766
references.citation: J Cardiovasc Electrophysiol. 2005 Aug;16(8):845-52
references.pmid: 16101625
references.citation: N Engl J Med. 1998 Sep 3;339(10):659-66
references.pmid: 9725923
references.citation: J Cardiovasc Electrophysiol. 2013 Feb;24(2):132-8
references.pmid: 23130991
references.citation: Stroke. 2003 Oct;34(10):2436-9
references.pmid: 12970519
references.citation: JAMA. 2001 Jun 13;285(22):2864-70
references.pmid: 11401607
references.citation: Cardiovasc Res. 1999 Oct;44(1):10-2
references.pmid: 10615384
references.citation: J Cardiovasc Med (Hagerstown). 2010 Aug;11(8):593-8
references.pmid: 20216228
references.citation: Virchows Arch. 2004 Nov;445(5):498-505
references.pmid: 15221371
references.citation: Circulation. 1995 Oct 1;92(7):1954-68
references.pmid: 7671380