Visualization of Pulmonary Vein-Left Atrium Reconduction Site on Delayed-Enhancement Magnetic Resonance Imaging in the Second Atrial Fibrillation Catheter Ablation

Cardiovasc electrophysiol

Fukuzawa

et al. 2019

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Introduction Pulmonary vein isolation (PVI) lesions after cryoballoon ablation (CBA) are wide and continuous, however, the distribution can depend on the pulmonary vein (PV) size. We sought to assess the relationship between the lesion distribution and PV size after CBA and hotballoon ablation (HBA). Methods and Results A total of 80 consecutive patients who underwent PVI were enrolled (40 with CBA). The lesions were visualized by late‐gadolinium enhancement magnetic resonance imaging. The lesion width, lesion gaps, and distance from the PV ostium (PVos) to distal lesion edge (DLE) were assessed. If the DLE extended inside the PV, the value was expressed as a negative value. Although the lesion width was significantly wider in the CB group (7.8 ± 2.0 vs 4.9 ± 1.0 mm, P < .001), the number of lesion gaps was significantly less in the HB group (2.9 ± 2.4 vs 1.3 ± 1.4 gaps, P = .001). The distance from the PVos to DLE was a negative value in both groups, but the impact was significantly greater (−1.5 ± 1.8 vs −0.2 ± 1.2 mm, P < .001) and negatively correlated with PV size in the CB group, but not in HB group (r = −0.27, P = .007). The AF recurrence 12 months after the procedure did not differ (5 [12.5%] of 40 in the CB group vs 4 [10%] of 40 in the HB group, P = .695). Conclusions The PVI lesions after HBA were characterized by (a) narrower, but (b) more continuous, (c) smaller lesion inside the PV, and (d) irrespective of PV size as compared to that after CBA.

Section: Methodsmentioning

confidence: 99%

Section: Mri Acquisitionmentioning

confidence: 99%

Lesion distribution after cryoballoon ablation and hotballoon ablation: Late‐gadolinium enhancement magnetic resonance imaging analysis

Akita

Cardiovasc electrophysiol

Fukuzawa

et al. 2019

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“…This scan technique has been established, and acquired images have been used for the AF ablation procedure . First, contrast enhancement–magnetic resonance angiography (CE‐MRA) of the PV–LA anatomy was acquired with a breath‐hold 3D fast field echo (FFE) sequence in the coronal plane during the first pass of a contrast agent (gadobutrol, Gadovist; Bayer Yakuhin, Osaka, Japan) injection at a dose of 0.1 mmol/kg . Then, the LGE‐MRI of the LA with PVs was acquired using a 3D inversion recovery, respiration‐navigated, electrocardiogram‐gated, T1‐FFE sequence in the transverse plane 15 min after a contrast injection, which have been previously reported .…”

Section: Methodsmentioning

confidence: 99%

The lesion characteristics assessed by LGE‐MRI after the cryoballoon ablation and conventional radiofrequency ablation

Kurose

Fukuzawa

et al. 2018

Journal of Arrhythmia

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BackgroundRhythm outcomes after the pulmonary vein isolation (PVI) using the cryoballoon (CB) are reported to be excellent. However, the lesions after CB ablation have not been well discussed. We sought to characterize and compare the lesion formation after CB ablation with that after radiofrequency (RF) ablation.MethodsA total of 42 consecutive patients who underwent PVI were enrolled (29 in the CB group and 13 in the RF group). The PVI lesions were assessed by late gadolinium enhancement magnetic resonance imaging 1–3 months after the PVI. The region around the PVs was divided into eight segments: roof, anterior‐superior, anterior‐carina, anterior‐inferior, bottom, posterior‐inferior, posterior‐carina, and posterior‐superior segment. The lesion width and lesion gap in each segment were compared between the two groups. Lesion gaps were defined as no‐enhancement sites of >4 mm.ResultsAs compared to the RF group, the overall lesion width was significantly wider and lesion gaps significantly fewer at the anterior‐superior segment of the left PV (LAS) and anterior‐inferior segment of the right PV (RAI) in the CB group (lesion width: 8.2 ± 2.2 mm vs 5.6 ± 2.0 mm, P = .001; lesion gap at LAS: 7% vs 38%, P = .02; lesion gap at RAI: 7% vs 46%, P = .006).ConclusionsThe PVI lesions after CB ablation were characterized by extremely wider and more continuous lesions than those after RF ablation.

“…A 3D visualization and segmentation of the MRI were performed with AZE Virtual Place (AZE Virtual Place; AZE, Tokyo, Japan). The method for the 3D visualization has been reported previously [3,12,13]. Briefly, we segmented the LA wall and calculated the mean value and standard deviation (SD) of the pixel intensity histogram.…”

Section: Methodsmentioning

confidence: 99%

Visualization of the radiofrequency lesion after pulmonary vein isolation using delayed enhancement magnetic resonance imaging fused with magnetic resonance angiography

Okajima

Shimane

et al. 2014

Journal of Arrhythmia

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