Open AccessFeasibility of late gadolinium enhancement magnetic resonance imaging to detect ablation lesion gaps in patients undergoing cryoballoon ablation of paroxysmal atrial fibrillation
Author(s) -
Mishima Tsuyoshi,
Miyamoto Koji,
Morita Yoshiaki,
Kamakura Tsukasa,
Nakajima Kenzaburo,
Yamagata Kenichiro,
Wada Mitsuru,
Ishibashi Kouhei,
Inoue Yuko,
Nagase Satoshi,
Noda Takashi,
Aiba Takeshi,
Izumi Chisato,
Noguchi Teruo,
Yasuda Satoshi,
Kusano Kengo
Publication year - 2019
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1002/joa3.12161
Subject(s) - medicine , ablation , magnetic resonance imaging , pulmonary vein , atrial fibrillation , radiology , catheter ablation , lesion , cardiology , nuclear medicine , pathology
Background Although late gadolinium enhancement magnetic resonance imaging ( LGE ‐ MRI ) allows the identification of lesions and gaps after a cryothermal balloon ( CB ) ablation of paroxysmal atrial fibrillation ( PAF ), the accuracy has not yet been well established. Methods The subjects consisted of 10 consecutive patients who underwent a second ablation procedure among our cohort of 80 patients who underwent LGE ‐ MRI after the CB ablation of PAF . LGE ‐ MRI scar regions were compared with electroanatomical mapping during the second procedure. In the analysis, the unilateral pulmonary vein ( PV ) antrum was divided into 7 regions. Results The gap characterization analysis was performed in 140 regions around 40 PV s in total. There were 16 LGE ‐ MRI gaps around 11 PV s (mean 1.6 ± 1.4 gaps/patient) in 7 patients and 14 electrical gaps around 10 PV s in 8 patients (mean 1.4 ± 1.1 gaps/patient). The locations of 13 electrical gaps were well matched to that on the LGE ‐ MRI , whereas the remaining 1 electrical gap had not been predicted on the LGE ‐ MRI . Compared to the electrical gaps in the second procedure, the sensitivity and specificity of the LGE ‐ MRI gaps were 93% (13 LGE ‐ MRI gaps of 14 electrical gaps) and 98% (123 LGE ‐ MRI scars out of 126 electrical scars), respectively. Conclusion LGE ‐ MRI can accurately localize the lesion gaps after CB ablation of PAF .