Cardiac magnetic resonance and electroanatomical mapping of acute and chronic atrial ablation injury: a histological validation study
Key result
Cardiac magnetic resonance and endocardial voltage mapping accurately defined atrial ablation injury, with optimal SI thresholds of 2.3 SD for acute LGE and 3.3 SD for chronic LGE.
Why the study?
Do specific signal intensity thresholds in CMR and endocardial voltage mapping accurately reflect acute and chronic atrial ablation injury compared to histopathology in a pig model?
Population
16 pigs undergoing intercaval linear radiofrequency ablation
Comparison
T2-weighted and late gadolinium enhancement CMR… vs Histopathological examination
Design
Preclinical
Follow-up
8 weeks for the chronic group
Authors
Discussion
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Member takes
Implication
Should not change clinical practice yet; leaves open optimal CMR thresholds for human atrial ablation assessment.
Structured PICO
Do specific signal intensity thresholds in CMR and endocardial voltage mapping accurately reflect acute and chronic atrial ablation injury compared to histopathology in a pig model?
P
Population
16 pigs undergoing intercaval linear radiofrequency ablation
I
Intervention
T2-weighted (T2W) and late gadolinium enhancement (LGE) CMR and high-density voltage mapping of the right atrium (RA) pre- and post-ablation
C
Comparator
Histopathological examination (real lesion volumes)
O
Outcome
Signal intensity (SI) thresholds that best approximate histological volumessurrogate
This study identifies specific signal intensity thresholds for CMR that best match histological lesion volumes for acute and chronic atrial ablation injury, providing a foundation for better assessment of atrial substrate post-ablation.
Cite This Study
Harrison et al. (2014) studied Atrial ablation injury (n=16). Cardiac magnetic resonance (T2W and LGE) and high-density voltage mapping vs. Histological examination was evaluated on Signal intensity (SI) thresholds that best approximated histological volumes. Cardiac magnetic resonance and endocardial voltage mapping accurately defined atrial ablation injury, with optimal SI thresholds of 2.3 SD for acute LGE and 3.3 SD for chronic LGE.