Relationship between intended sites of RF ablation and post-procedural scar in AF patients, using late gadolinium enhancement cardiovascular magnetic resonance
Relationship between intended sites of RF ablation and post-procedural scar in AF patients, using late gadolinium enhancement cardiovascular magnetic resonance
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DOI：
10.1016/j.hrthm.2009.12.007
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发表时间：
2010-04-01
期刊：
影响因子：
5.5
通讯作者：
Peters, Dana C.
中科院分区：
文献类型：
--
作者：
Taclas, Jason E.;Nezafat, Reza;Peters, Dana C.
背景技术背景：房颤（AF）患者的左心房（LA）射频（RF）消融由电解剖标测系统引导。心血管磁共振（CMR）晚期钆增强（LGE）技术可以检测消融后的瘢痕。还没有对预期的射频消融部位和左心房瘢痕形成部位进行直接比较。目的：本研究旨在开发和使用一种方法，用于比较左心房射频消融部位和术后瘢痕形成部位。方法：CMR LGE图像与电解剖标测数据的刚性配准方法（Carto数据），配准数据集的可视化和相关性的量化被开发并用于19项AF患者研究。Carto点和CMR LA表面之间的距离被测量为平均积分误差。测量每次Carto消融与最近瘢痕之间的距离。在每个肺静脉的6个扇区中，还对LGE和Carto消融部位的间隙进行了定性评估。自定义配准方法提供的Carto和CMR之间的平均积分误差为2.7 +/- 0.7 mm。Carto和LGE瘢痕之间的平均距离为3.6 +/- 1.3 mm。结论：Carto消融部位与LGE瘢痕之间存在视觉和定量的对应关系，但20%的Carto消融部位没有可见的对应LGE。
BACKGROUND: Radiofrequency (RF) ablation of the left atrium (LA) in patients with atrial fibrillation (AF) is guided by electroanatomic mapping systems. The cardiovascular magnetic resonance (CMR) late gadolinium enhancement (LGE) technique can detect scar after ablation. Direct comparisons between the locations of intended RF ablation sites and locations of scar formation in the LA have not been performed.OBJECTIVE: This study sought to develop and use a method for comparing the sites of RF application with the sites of post-procedural scar formation in the LA.METHODS: A method for rigid registration of CMR LGE images with electroanatomic mapping data (Carto data), visualization of the registered data sets, and quantification of the correlations was developed and used in 19 studies of patients with AF. The distance between the Carto points and the CMR LA surface was measured as the mean integration error. The distance between each Carto ablation and the nearest scar was measured. The gaps in sites of LGE and in Carto ablation were also assessed qualitatively, in 6 sectors of each PV.RESULTS: The custom registration method provided a mean integration error between Carto and CMR of 2.7 +/- 0.7 mm. The average distance between Carto and LGE scar was 3.6 +/- 1.3 mm. Qualitatively, 20% of sectors with sites of Carto ablation showed no evidence of LGE.CONCLUSION: There was a visual and quantitative correspondence between Carto ablation sites and LGE scar, but for 20% of Carto ablation sites there was no visible corresponding LGE.