Key result
Non-contrast MRI shows similar surface registration error and procedure time to CE-CT in AF ablation.
Why the study?
Does non-contrast-enhanced MRI with 2D b-SSFP provide comparable procedural outcomes to contrast-enhanced CT in patients undergoing atrial fibrillation ablation?
Cohort (n=54)
Does non-contrast-enhanced MRI with 2D b-SSFP provide comparable procedural outcomes to contrast-enhanced CT in patients undergoing atrial fibrillation ablation?
Absolute Event Rate: 1% vs 1%
p-value: p=0.88
Non-contrast-enhanced MRI with a 2D b-SSFP sequence provides adequate anatomical information for AF ablation without radiation or contrast exposure, yielding similar procedural outcomes to contrast-enhanced CT.
May support non-contrast MRI to avoid contrast/radiation in AF ablation; leaves open randomized confirmation of outcomes.
BACKGROUND: To investigate the feasibility of substituting non-contrast-enhanced MR (non-CE-MR) imaging with a two-dimensional (2D) balanced steady-state free precession (b-SSFP) sequence for contrast-enhanced computed tomography (CE-CT) for atrial fibrillation (AF) ablation. METHODS: Fifty-four patients that underwent AF ablation under the guidance of a 3D electro-anatomical mapping system with CE-CT (n = 27) or non-CE-MR images (n = 27) were studied. Procedural results were compared between the two groups. Furthermore, in 22 patients who underwent both CE-CT and non-CE-MRI, two cardiologists independently scored the multiplanar reformatted images on a scale of 1 to 4 (from 1, poor, to 4, excellent). RESULTS: The image score was nearly 0.5 point higher with the CE-CT method. However, the procedural results such as the surface registration error (1.0 [0.8-1.6] mm versus 1.0 [0.8-1.35] mm, P = 0.88) and procedure time (185 [159-199] min versus 185 [142-221] min, P = 0.86) did not significantly differ between the CE-CT and non-CE-MR groups. CONCLUSION: The non-CE-MR method with a 2D-b-SSFP sequence can give us adequate information on AF ablation without any radiation exposure or contrast medium usage
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Shigenaga et al. (2015) conducted a cohort in Atrial fibrillation (n=54). Non-contrast-enhanced MRI with a 2D balanced steady-state free precession sequence vs. Contrast-enhanced computed tomography (CE-CT) was evaluated on Surface registration error (p=0.88). Non-contrast-enhanced MRI yielded similar surface registration error (1.0 vs 1.0 mm, P=0.88) and procedure time (185 vs 185 min, P=0.86) compared to CE-CT during atrial fibrillation ablation.
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