Document Detail

Temporal left atrial lesion formation after ablation of atrial fibrillation.
MedLine Citation:
PMID:  19187904     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Atrial fibrillation (AF) ablation uses radiofrequency (RF) energy to induce thermal damage to the left atrium (LA) in an attempt to isolate AF circuits. This injury can be seen using delayed enhancement magnetic resonance imaging (DE-MRI). OBJECTIVE: The purpose of this study was to describe DE-MRI findings of the LA in the acute and chronic stages postablation. METHODS: Twenty-five patients were scanned at two time points postablation. The first group (n = 10) underwent DE-MRI at 24 hours and at 3 months. The second group (n = 16) was scanned at 3 months and at 6 or 9 months. One patient had three scans (24 hours, 3 months, 9 months) and was included in both groups. The location and extent of enhancement were then analyzed between both groups. RESULTS: The median change in LA wall injury between 24 hours and 3 months was -6.38% (range -11.7% to 12.58%). The median change in LA wall injury between 3 months and later follow-up was +2.0% (range -4.0% to 6.58%). There appears to be little relationship between the enhancement at 24 hours and 3 months (R(2) = 0.004). In contrast, a strong correlation is seen at 3 months and later follow-up (R(2) = 0.966). Qualitative comparison revealed a stronger qualitative relationship between MRI findings at 3 months and later follow-up than at 24 hours and 3 months. CONCLUSION: RF-induced scar appears to have formed by 3 months postablation. At 24 hours postablation, DE-MRI enhancement appears consistent with a transient inflammatory response rather than stable LA scar formation.
Troy J Badger; Robert S Oakes; Marcos Daccarett; Nathan S Burgon; Nazem Akoum; Eric N Fish; Joshua J E Blauer; Swati N Rao; Yaw Adjei-Poku; Eugene G Kholmovski; Sathya Vijayakumar; Edward V R Di Bella; Rob S MacLeod; Nassir F Marrouche
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-11-06
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  6     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-03     Completed Date:  2009-07-07     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  161-8     Citation Subset:  IM    
Atrial Fibrillation Program, Division of Cardiology, University of Utah School of Medicine, Salt Lake City, Utah 84132-2400, USA.
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MeSH Terms
Atrial Fibrillation / physiopathology,  surgery*
Catheter Ablation / methods*
Cicatrix / diagnosis*
Contrast Media / administration & dosage
Heart Atria / physiopathology,  surgery*
Image Interpretation, Computer-Assisted
Imaging, Three-Dimensional
Magnetic Resonance Imaging / methods*
Middle Aged
Postoperative Complications / diagnosis*
Pulmonary Veins / physiopathology,  surgery
Statistics, Nonparametric
Treatment Outcome
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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