Lesion formation after pulmonary vein isolation using the advance cryoballoon and the standard cryoballoon: lessons learned from late gadolinium enhancement magnetic resonance imaging

Abstract

Cardiac MRI is able to visualize induced ablation lesions after PVI and might be suitable to quantify ablation lesion amount. Ablation lesion formation did not differ significantly in patients treated with the CB-S vs. the CB-A, despite a significantly lower rate of AF recurrence after 3 months in the CB-A group. Left PVs showed a significantly higher amount of ablation lesions compared with the right PVs. Larger and randomized studies are needed to understand the relationship between representable tissue lesions and success rates.

Mind the gap: Quantification of incomplete ablation patterns after pulmonary vein isolation using minimum path search

“…Some works can be found in the literature (Peters et al, 2007;Badger et al, 2010;Halbfass et al, 2015) to characterize ablation gaps but all of them rely on visual inspection of complex 3D data by several observers. This approach can be difficult, time-consuming and inaccurate if not performed in a consistent and unbiased way.…”

Visualization of pulmonary vein–left atrium lesions using delayed-enhancement magnetic resonance imaging after cryothermal balloon catheter ablation: A case report

“…Hunter et al and Halbfass et al have previously shown DE-MRI as a method for assessing the lesion set after CB ablation 12, 13. In these reports, however, the relationship between the DE-MRI findings and the detailed CB ablation procedure was not investigated.…”

“…Although it may offer the invaluable advantage of achieving PV isolation with a single application, little is known about the extension of the PV–left atrium (LA) lesion after the procedure in clinical practice. Although delayed-enhancement magnetic resonance imaging (DE-MRI) has been reported as a noninvasive tool for visualizing lesions after radiofrequency or CB ablation,9, 10, 11, 12, 13 the relationship between the CB ablation procedure and lesions on DE-MRI results has not yet been assessed in detail.…”

Combined Angiography and Late Gadolinium Enhancement Acquisition to Improve Assessment of Pulmonary Vein Isolation for Atrial Fibrillation

“…Magnetic resonance imaging (MRI) is capable of differentiating between scarred and nonscarred atrial wall by using late gadolinium enhancement (LGE) imaging . To perform LGE of the atrial wall, a 3D, navigator‐ and electrocardiogram (ECG)‐gated, inversion recovery (IR)‐prepared fast low angle shot (FLASH) sequence is employed . Imaging is performed 15–25 minutes after contrast injection to allow sufficient time for contrast to accumulate into scar, and slices are acquired in the transverse orientation for full atrial coverage.…”

“…[8][9][10][11] To perform LGE of the atrial wall, a 3D, navigator-and electrocardiogram (ECG)-gated, inversion recovery (IR)-prepared fast low angle shot (FLASH) sequence is employed. 8,12,13 Imaging is performed 15-25 minutes after contrast injection to allow sufficient time for contrast to accumulate into scar, and slices are acquired in the transverse orientation for full atrial coverage. The atrial wall is then extracted, by manually segmenting the LGE images, or semiautomatically segmenting the angiographic images that are coregistered to the LGE images.…”