Why the study?
Atrial inflammation promotes atrial fibrosis and AF, but methods to visualize atrial inflammation have not been established.
Does PET/MRI detect atrial inflammation after cryoballoon ablation, and does it correlate with consequent fibrosis in patients with paroxysmal atrial fibrillation?
Does PET/MRI detect atrial inflammation after cryoballoon ablation, and does it correlate with consequent fibrosis in patients with paroxysmal atrial fibrillation?
PET/MRI can successfully visualize atrial inflammation following cryoballoon ablation, revealing a strong correlation between early inflammation and subsequent lesion maturation (fibrosis).
Supports PET/MRI feasibility for post-cryoballoon inflammation detection; hypothesis-generating for inflammation-fibrosis correlation, requires prospective validation before clinical use.
Background Atrial inflammation plays an important role in initiating atrial fibrosis, which could perpetuate atrial fibrillation (AF). However, the method of visualization of atrial inflammation has not been established. We sought to investigate whether the intensive atrial inflammation caused by cryoballoon ablation (CBA) could be detected by positron emission tomography/ magnetic resonance imaging (PET/MRI) and whether the atrial inflammation could be associated with consequent fibrosis. Methods A total of 10 paroxysmal atrial fibrillation patients after CBA were enrolled. To detect and quantify intensive atrial inflammation, PET/MRI was performed to assess regional 18 F‐fluorodeoxyglucose ( 18 F‐FDG) uptake one day after the CBA, and the standardized uptake values (SUV) max were compared between the pulmonary vein (PV) antrum where CBA could be applied and the healthy left atrial (LA) wall where CBA could not be applied. Furthermore, the atrial inflammation one day after the procedure and atrial fibrosis areas one month after the procedure were three‐dimensionally quantified by PET/MRI and late‐gadolinium enhancement magnetic resonance imaging (LGE‐MRI), respectively. Results The mean SUV max at the PV antrum was significantly higher than that on the healthy LA wall (2.12 ± 0.35 vs 1.73 ± 0.30, P = .00021). The volume of the atrial inflammation strongly correlated with that of the atrial fibrosis ( r = .94 [.76‐.99], P = .00006). Conclusions The atrial inflammation after CBA could be detected by PET/MRI. CBA‐induced atrial inflammation was strongly associated with consequent lesion maturation.
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Kiuchi et al. (2020) studied this question.
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