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MRI PREDICTS SCAR FORMATION AFTER AF ABLATION

Permanent scarring in the months following ablation can be predicted by regions of no-reflow on late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) performed immediately after the procedure, according to a study published recently in the Journal of the American College of Cardiology.1

Dr Christopher McGann and colleagues (University of Utah, Salt Lake City) enrolled 37 patients presenting for atrial fibrillation (AF) ablation, who underwent high-resolution MRI with a 3-dimensional LGE sequence before ablation, immediately after, and three months after the procedure.

Acute left atrial wall injuries on scans taken immediately after ablation were categorised as either nonenhanced (NE) or hyperenhanced (HE), defined respectively at three standard deviations below and above each patient’s normal tissue mean pixel intensity.

The authors found that dark NE lesions, demonstrating no-reflow characteristics, were associated with significantly greater permanent scarring three months after ablation.  They assert that the link between scarring and patient outcome means this association may “expand the utility of LGE MRI to help guide ablation at the time of the procedure”.

Reference

1 McGann C, Kholmovski E, Blauer J, et al. Dark regions of no-reflow on late gadolinium enhancement magnetic resonance imaging result in scar formation after atrial fibrillation ablation. JACC 2011;58:177-85.

Published on: July 6, 2011

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ENDORSED BY

  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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