Temporal left atrial lesion formation after ablation of atrial fibrillation
Temporal left atrial lesion formation after ablation of atrial fibrillation
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DOI：
10.1016/j.hrthm.2008.10.042
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发表时间：
2009-02-01
期刊：
影响因子：
5.5
通讯作者：
Marrouche, Nassir F.
中科院分区：
文献类型：
--
作者：
Badger, Troy J.;Oakes, Robert S.;Marrouche, Nassir F.
背景房颤（AF）消融术使用射频（RF）能量诱导左心房（LA）热损伤，试图隔离AF回路。这种损伤可以看出，使用延迟增强磁共振成像（DE-MRI）。目的本研究的目的是描述DE-MRI结果的LA在急性和慢性阶段postablation.METHODS 25例患者进行了扫描，在两个时间点postablation。第一组（n = 10）在24小时和3个月时接受了DE-MRI。第二组（n = 16）在3个月和6个月或9个月时进行扫描。1例患者接受了3次扫描（24小时、3个月、9个月），并被纳入两组。结果24小时和3个月之间左心房壁损伤的中位变化为-6.38%（范围-11.7%至12.58%）。3个月与后续随访之间的LA瓦特损伤的中位变化为+2.0%（范围为-4.0%至6.58%）。在24小时和3个月的增强之间似乎没有什么关系（R-2 = 0.004）。相比之下，在3个月和以后的随访中观察到强相关性（R-2 = 0.966）。定性比较显示，更强的定性关系，MRI结果在3个月后随访比在24小时和3 month.CONCLUSION射频诱导的瘢痕似乎已形成3个月后消融。消融后24小时，DE-MRI增强似乎与一过性炎症反应一致，而不是稳定的LA瘢痕形成。
BACKGROUND Atrial fibrillation (AF) ablation uses radio-frequency (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 watt 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.