Feasibility of late gadolinium enhancement magnetic resonance imaging to detect ablation lesion gaps in patients undergoing cryoballoon ablation of paroxysmal atrial fibrillation
Feasibility of late gadolinium enhancement magnetic resonance imaging to detect ablation lesion gaps in patients undergoing cryoballoon ablation of paroxysmal atrial fibrillation
复制标题
晚期钆增强磁共振成像检测阵发性房颤冷冻球囊消融患者消融病灶间隙的可行性
DOI：
10.1002/joa3.12161
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发表时间：
2019
影响因子：
2
通讯作者：
Kusano Kengo
中科院分区：
文献类型：
--
作者：
Mishima Tsuyoshi;Miyamoto Koji;Morita Yoshiaki;Kamakura Tsukasa;Nakajima Kenzaburo;Yamagata Kenichiro;Wada Mitsuru;Ishibashi Kouhei;Inoue Yuko;Nagase Satoshi;Noda Takashi;Aiba Takeshi;Izumi Chisato;Noguchi Teruo;Yasuda Satoshi;Kusano Kengo
BackgroundAlthough迟发性钆增强磁共振成像（LGE-MRI）可以识别阵发性心房颤动（PAF）的冷冻球囊（CB）消融后的病变和间隙，准确性尚未得到很好的确立。MethodsThe subjects包括10例连续患者，他们在我们的80例患者中接受了第二次消融术，这些患者在房颤CB消融后接受了LGE-MRI。在第二次手术期间，将LGE-MRI瘢痕区域与电解剖标测进行了比较。在分析中，单侧肺静脉（PV）胃窦被分为7个regions.ResultsThe间隙表征分析进行了140个区域周围的40个PV。7例患者的11个肺静脉周围有16个LGE-MRI间隙（平均1.6 ± 1.4个间隙/患者），8例患者的10个肺静脉周围有14个电间隙（平均1.4 ± 1.1个间隙/患者）。13个电气间隙的位置与LGE-MRI上的位置匹配良好，而其余1个电气间隙未在LGE-MRI上预测。与第二次手术中的电间隙相比，LGE-MRI间隙的敏感性和特异性分别为93%（14个电间隙中的13个LGE-MRI间隙）和98%（126个电瘢痕中的123个LGE-MRI瘢痕）。
BackgroundAlthough late gadolinium enhancement magnetic resonance imaging (LGE‐MRI) allows the identification of lesions and gaps after a cryothermal balloon (CB) ablation of paroxysmal atrial fibrillation (PAF), the accuracy has not yet been well established.MethodsThe subjects consisted of 10 consecutive patients who underwent a second ablation procedure among our cohort of 80 patients who underwent LGE‐MRI after the CB ablation of PAF. LGE‐MRI scar regions were compared with electroanatomical mapping during the second procedure. In the analysis, the unilateral pulmonary vein (PV) antrum was divided into 7 regions.ResultsThe gap characterization analysis was performed in 140 regions around 40 PVs in total. There were 16 LGE‐MRI gaps around 11 PVs (mean 1.6 ± 1.4 gaps/patient) in 7 patients and 14 electrical gaps around 10 PVs in 8 patients (mean 1.4 ± 1.1 gaps/patient). The locations of 13 electrical gaps were well matched to that on the LGE‐MRI, whereas the remaining 1 electrical gap had not been predicted on the LGE‐MRI. Compared to the electrical gaps in the second procedure, the sensitivity and specificity of the LGE‐MRI gaps were 93% (13 LGE‐MRI gaps of 14 electrical gaps) and 98% (123 LGE‐MRI scars out of 126 electrical scars), respectively.ConclusionLGE‐MRI can accurately localize the lesion gaps after CB ablation of PAF.