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Comparison of Left Atrial Area Marked Ablated in Electroanatomical Maps with Scar in MRI
Author(s) -
PARMAR BHRIGU R.,
JARRETT TYLER R.,
BURGON NATHAN S.,
KHOLMOVSKI EUGENE G.,
AKOUM NAZEM W.,
HU NAN,
MACLEOD ROB S.,
MARROUCHE NASSIR F.,
RANJAN RAVI
Publication year - 2014
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12357
Subject(s) - medicine , magnetic resonance imaging , ablation , atrial fibrillation , radiology , pulmonary vein , catheter ablation , cardiac magnetic resonance , nuclear medicine , multidetector computed tomography , left atrium , cardiology , computed tomography
Electroanatomic Map Overestimates the Ablated Area Background Three‐dimensional electroanatomic mapping (EAM) is routinely used to mark ablated areas during radiofrequency ablation. We hypothesized that, in atrial fibrillation (AF) ablation, EAM overestimates scar formation in the left atrium (LA) when compared to the scar seen on late‐gadolinium enhancement magnetic resonance imaging (LGE‐MRI). Methods and Results Of the 235 patients who underwent initial ablation for AF at our institution between August 2011 and December 2012, we retrospectively identified 70 patients who had preprocedural magnetic resonance angiography merged with LA anatomy in EAM software and had a 3‐month postablation LGE‐MRI for assessment of scar. Ablated area was marked intraprocedurally using EAM software and quantified retrospectively. Scarred area was quantified in 3‐month postablation LGE‐MRI. The mean ablated area in EAM was 30.5 ± 7.5% of the LA endocardial surface and the mean scarred area in LGE‐MRI was 13.9 ± 5.9% (P < 0.001). This significant difference in the ablated area marked in the EAM and scar area in the LGE‐MRI was present for each of the 3 independent operators. Complete pulmonary vein (PV) encirclement representing electrical isolation was observed in 87.8% of the PVs in EAM as compared to only 37.4% in LGE‐MRI (P < 0.001). Conclusions In AF ablation, EAM significantly overestimates the resultant scar as assessed with a follow‐up LGE‐MRI.