title: Left atrial tachycardia after atrial fibrillation ablation: can magnetic resonance imaging assist the ablation?
abstract: We present a case of a magnetic resonance imaging-assisted ablation of an atrial tachycardia in a patient with previous atrial fibrillation ablation. A 3-D reconstruction of the delayed-enhanced cardiac magnetic resonance (CMR; CMR model) was created to identify previous ablation lesions and gaps. Multiple gaps around right-sided pulmonary veins were observed. The activation map identified a dual-loop re-entry around both right-sided pulmonary veins, confirming that the substrate identified using delayed-enhanced CMR was critical to sustain the tachycardia. Ablation at this site converted to sinus rhythm. The present case shows the usefulness of delayed-enhanced CMR substrate characterization to complement activation mapping of the tachycardia and more accurately define the anatomical circuit.
authors.affiliation: Arrhythmia Section, Cardiology Department, Hospital Clínic, Barcelona, Spain. Electronic address: f.bisbalvb@gmail.com.
authors.forename: Felipe
authors.initials: F
authors.lastname: Bisbal
authors.affiliation: Arrhythmia Section, Cardiology Department, Hospital Clínic, Barcelona, Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Calvo
authors.affiliation: Arrhythmia Section, Cardiology Department, Hospital Clínic, Barcelona, Spain.
authors.forename: Emilce
authors.initials: E
authors.lastname: Trucco
authors.affiliation: Arrhythmia Section, Cardiology Department, Hospital Clínic, Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Arbelo
authors.affiliation: Arrhythmia Section, Cardiology Department, Hospital Clínic, Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Berruezo
authors.affiliation: Arrhythmia Section, Cardiology Department, Hospital Clínic, Barcelona, Spain.
authors.forename: Lluís
authors.initials: L
authors.lastname: Mont
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology*; D017115:Catheter Ablation / Q000379:methods*; D006325:Heart Atria / Q000473:pathology*; D006329:Heart Conduction System / Q000473:pathology / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000601:surgery*