Visualization and Temporal/Spatial Characterization of Cardiac Radiofrequency Ablation Lesions Using Magnetic Resonance Imaging

Lardo, Albert C.; McVeigh, Elliot R.; Jumrussirikul, Pitayadet; Berger, Ronald D.; Calkins, Hugh; Lima, João A.C.; Halperin, Henry R.

doi:10.1161/01.cir.102.6.698

Cited by 203 publications

(183 citation statements)

References 19 publications

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“…To improve the spatial resolution (Ͻ1 mm), we used antenna guide wires that crossed the ASD (Figure 2), allowing for a very small FOV (eg, 5ϫ5 cm). 4,5 We found an excellent correlation between this method of ASD sizing and postmortem sizing, compared with conventional gradient-echo cine-MRI without antenna guide wires ( Figure 5). …”

Section: Asd Sizingmentioning

confidence: 73%

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Magnetic Resonance Image-Guided Transcatheter Closure of Atrial Septal Defects

Rickers

Jerosch‐Herold

et al. 2003

Circulation

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Background-Recent developments in cardiac MRI have extended the potential spectrum of diagnostic and interventional applications. The purpose of this study was to test the ability of MRI to perform transcatheter closures of secundum type atrial septal defects (ASD) and to assess ASD size and changes in right cardiac chamber volumes in the same investigation. Methods and Results-In 7 domestic swine (body weight, 38Ϯ13 kg), an ASD (Q p :Q s ϭ1.7Ϯ0.2) was created percutaneously by balloon dilation of the fossa ovalis. The ASD was imaged and sized by both conventional radiography and MRI. High-resolution MRI of the ASD diameters correlated well with postmortem examination (rϭ0.97). Under real-time MR fluoroscopy, the introducer sheath was tracked toward the left atrium with the use of novel miniature MR guide wires. The defect was then closed with an Amplatzer Septal Occluder. In all animals, it was possible to track and interactively control the position of the guide wire within the vessels and the heart, including the successful deployment of the Amplatzer Septal Occluder. Right atrial and ventricular volumes were calculated before and after the intervention by using cine-MRI. Both volumes were found to be significantly reduced after ASD closure (PϽ0.005). Conclusions-These

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Section: Asd Sizingmentioning

confidence: 73%

“…Additionally, high-resolution anatomic and functional imaging can be performed in the same study. 4,5 However, the capability of MRI for percutaneous device closure of intracardiac shunts has not yet been demonstrated. In the past 30 years, numerous devices have undergone investigation for percutaneous atrial septal defect (ASD) closure.…”

mentioning

confidence: 99%

Magnetic Resonance Image-Guided Transcatheter Closure of Atrial Septal Defects

Rickers

Jerosch‐Herold

et al. 2003

Circulation

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“…Positron emission tomography (PET), computed tomography (CT), magnetic resonance imaging (MRI) and echocardiography have all demonstrated capabilities in assessing myocardial function by measuring perfusion of contrast agents into and out of the intercellular space of cardiac tissue (Gerber et al, 2002;Klein et al, 2002;Koyama et al, 2004;Lardo et al, 2000;Yu et al, 2004). However, the potential complications with the use of contrast agents as well as the cost of these imaging modalities are limiting factors for their widespread clinical application.…”

Section: Introductionmentioning

confidence: 99%

In Vivo Assessment of Myocardial Stiffness with Acoustic Radiation Force Impulse Imaging

Hsu¹,

Bouchard²,

Dumont³

et al. 2007

Ultrasound in Medicine & Biology

112

106

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Acoustic radiation force impulse (ARFI) imaging has been demonstrated to be capable of visualizing variations in local stiffness within soft tissue. Recent advances in ARFI beam sequencing and parallel imaging have shortened acquisition times and lessened transducer heating to a point where ARFI acquisitions can be executed at high frame rates on commercially available diagnostic scanners. In vivo ARFI images were acquired with a linear array placed on an exposed canine heart. The electrocardiogram (ECG) was also recorded. When co-registered with the ECG, ARFI displacement images of the heart reflect the expected myocardial stiffness changes during the cardiac cycle. A radiofrequency ablation was performed on the epicardial surface of the left ventricular free wall, creating a small lesion that did not vary in stiffness during a heartbeat, though continued to move with the rest of the heart. ARFI images showed a hemispherical, stiffer region at the ablation site whose displacement magnitude and temporal variation through the cardiac cycle were less than the surrounding untreated myocardium. Sequences with radiation force pulse amplitudes set to zero were acquired to measure potential cardiac motion artifacts within the ARFI images. The results show promise for real-time cardiac ARFI imaging.

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“…Most important, however, MRI allows for visualization of ablated tissue during the procedure. (7). Because lesions are invisible under X-ray fluoroscopy, it is currently difficult to discern whether tissue has been completely ablated, is only temporarily stunned (i.e., subject to reversible thermal injury), or has not been treated at all (6).…”

mentioning

confidence: 99%

“…Finally, it must be possible to deliver RF energy for ablation of the desired tissue near the catheter tip. Previous work by our group has demonstrated the feasibility of delivering RF energy for cardiac ablation within the MRI scanner (7). Therefore, the present work will focus on only the first two functions.…”

mentioning

confidence: 99%

Multifunctional interventional devices for MRI: A combined electrophysiology/MRI catheter

Susil

Yeung

Halperin

et al. 2002

Magnetic Resonance in Med

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The design and application of a two-wire electrophysiology (EP) catheter that simultaneously records the intracardiac electrogram and receives the MR signal for active catheter tracking is described. The catheter acts as a long loop receiver, allowing for visualization of the entire catheter length while simultaneously behaving as a traditional two-wire EP catheter, allowing for intracardiac electrogram recording and ablation. The application of the device is demonstrated by simultaneously tracking the catheter and recording the intracardiac electrogram in canine models using 7 and 10 frame/sec real-time imaging sequences. Using solely MR imaging, the entire catheter was visualized and guided from the jugular vein into the cardiac chambers, where the intracardiac electrogram was recorded. By combining several functions in a single, simple structure, the excellent tissue contrast and functional imaging capabilities of MR can be used to improve the efficacy of EP interventions. This catheter will facilitate MR-guided interventions and demonstrates the design of multifunctional interventional devices for use in MRI. Magn Reson Med 47: 594 -600, 2002.

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Visualization and Temporal/Spatial Characterization of Cardiac Radiofrequency Ablation Lesions Using Magnetic Resonance Imaging

Cited by 203 publications

References 19 publications

Magnetic Resonance Image-Guided Transcatheter Closure of Atrial Septal Defects

Magnetic Resonance Image-Guided Transcatheter Closure of Atrial Septal Defects

In Vivo Assessment of Myocardial Stiffness with Acoustic Radiation Force Impulse Imaging

Multifunctional interventional devices for MRI: A combined electrophysiology/MRI catheter

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