Key result
DCE-MRI differentiates between lesion core, edema, and normal myocardium in acute post-RF ablation, though acute no-reflow volume overestimates final lesion size at 3 months.
The study aims to investigate the correspondence between acute no-reflow seen on MRI and 3-month post-ablation scar.
Acute DCE-MRI overestimation cautions against relying on no-reflow volume for lesion sizing; leaves open its predictive value for chronic scar.
Background Radiofrequency (RF) ablation of myocardial tissue is a clinically acceptable therapy for atrial fibrillation and ventricular tachycardia. LGE-MRI has been used to assess immediately post-ablation RF lesions. It was shown that appearance of acute lesions in LGE-MRI changes with time after contrast injection [1,2]. Dickfeld, et al. [1] studied ventricular RF lesions delivered epicardially. They have shown that lesion core corresponds to regions of no-reflow with enhancement only at the boundaries in early LGE. Enhancement was shown to propagate inside lesion core in late LGE scans. Whereas, presence of considerable enhancement in regions of edema surrounding the no-reflow core of acute atrial lesions was shown in [2]. This obvious difference between these works was investigated and correspondence between acute no-reflow and 3 months post ablation scar was studied. Methods
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Vijayakumar et al. (2014) studied Cardiac RF ablation lesions (n=5). DCE-MRI was evaluated on Correlation between volume of no-reflow from acute study and volume of permanent scar at 3 months. DCE-MRI differentiates between lesion core, edema, and normal myocardium in acute post-RF ablation, though acute no-reflow volume overestimates final lesion size at 3 months.
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