High-resolution, free-breathing, fat-suppressed 3D Late Gadolinium Enhancement to define atrial wall scar after atrial fibrillation ablation

Atrial fibrillation (AF) ablation procedures still face challenges to achieve durable restoration of sinus rhythm. Advanced cardiac MRI delayed enhancement can delineate atrial wall scar to aid in planning AF ablation. However, thin atrial walls demand more advanced sequence development. In this study, we report protocol optimizations for high-resolution, free-breathing, fat-suppressed 3D LGE to detect atrial wall scar. In three AF patients to date, we found progressive improvements in CNR and detailed the sequence modification that led to these improvements. Future iterations will be used to assess atrial scar in patients, pre- and post-AF ablation.