Visualization of the radiofrequency lesion after pulmonary vein isolation using delayed enhancement magnetic resonance imaging fused with magnetic resonance angiography.
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.
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Kunihiko
K
Kiuchi
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Katsunori
K
Okajima
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Akira
A
Shimane
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Kiminobu
K
Yokoi
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Jin
J
Teranishi
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Kousuke
K
Aoki
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Misato
M
Chimura
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Hideo
H
Tsubata
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Taishi
T
Miyata
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Yuuki
Y
Matsuoka
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Takayoshi
T
Toba
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Shogo
S
Ohishi
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Takahiro
T
Sawada
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Yasue
Y
Tsukishiro
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Tetsuari
T
Onishi
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Seiichi
S
Kobayashi
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Shinichiro
S
Yamada
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Yasuyo
Y
Taniguchi
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Yoshinori
Y
Yasaka
Department of Cardiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Hiroya
H
Kawai
Department of Laboratory and Radiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Kazushi
K
Ikeuchi
Department of Laboratory and Radiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Yutaka
Y
Shigenaga
Department of Laboratory and Radiology, Himeji Cardiovascular Center, 520 kou saishou, Himeji, Hyogo, Japan.
Takayuki
T
Ikeda
AF, atrial fibrillation; Atrial fibrillation; Catheter ablation; DE-MRI, delayed enhancement magnetic resonance imaging; Delayed enhancement MRI; LA, left atrium; MRA; MRA, magnetic resonance angiography; PV, pulmonary vein; RF, radiofrequency; Radiofrequency lesions