Tags

Type your tag names separated by a space and hit enter

Assessment of radiofrequency ablation lesions by CMR imaging after ablation of idiopathic ventricular arrhythmias.
JACC Cardiovasc Imaging. 2010 Mar; 3(3):278-85.JC

Abstract

OBJECTIVES

To identify and characterize ablation lesions after radiofrequency (RF) catheter ablation of ventricular arrhythmias in patients without prior myocardial infarction and to correlate the ablation lesions with the amount of RF energy delivered and the clinical outcome.

BACKGROUND

Visualization of RF energy lesions after ablation of ventricular arrhythmias might help to identify reasons for ablation failure.

METHODS

In a consecutive series of 35 patients (19 women, age: 48 +/- 15 years, ejection fraction: 0.56 +/- 0.12) without structural heart disease who were referred for ablation of ventricular arrhythmias, cardiac magnetic resonance imaging with delayed enhancement was performed before and after ablation. Ablation lesions were sought in the post-ablation cardiac magnetic resonance images. The endocardial area, depth, and volume of the lesions were measured. Lesion size was correlated with the type of ablation catheter used and the duration of RF energy delivered.

RESULTS

In 25 of 35 patients (71%), ablation lesions were identified by delayed enhancement a mean of 22 +/- 12 months after the initial ablation procedure. The mean lesion volume was 1.4 +/- 1.4 cm(3), with a mean endocardial area of 3.5 +/- 3.0 cm(2). The largest lesions (mean volume of 2.9 +/- 2.1 cm(3) with an endocardial area of 6.4 +/- 3.4 cm(2)) were identified in patients in whom the arrhythmias originated in the papillary muscles. Ablation duration correlated with lesion size (r = 0.67, p < 0.001). There was no difference in lesion volume with irrigated versus nonirrigated ablation catheters (1.0 +/- 0.73 vs. 2.0 +/- 2.1 cm(3), p = 0.09). Identification of ablation lesions in patients with a failed procedure identified the sites where ineffective RF energy lesions were created.

CONCLUSIONS

RF ablation lesions can be detected long term after an ablation procedure targeting ventricular arrhythmias in patients without previous infarction. Lesion size correlates with the amount of RF energy delivered and is largest when a targeted arrhythmia originates in a papillary muscle.

Authors+Show Affiliations

Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20223425

Citation

Ilg, Karl, et al. "Assessment of Radiofrequency Ablation Lesions By CMR Imaging After Ablation of Idiopathic Ventricular Arrhythmias." JACC. Cardiovascular Imaging, vol. 3, no. 3, 2010, pp. 278-85.
Ilg K, Baman TS, Gupta SK, et al. Assessment of radiofrequency ablation lesions by CMR imaging after ablation of idiopathic ventricular arrhythmias. JACC Cardiovasc Imaging. 2010;3(3):278-85.
Ilg, K., Baman, T. S., Gupta, S. K., Swanson, S., Good, E., Chugh, A., Jongnarangsin, K., Pelosi, F., Crawford, T., Oral, H., Morady, F., & Bogun, F. (2010). Assessment of radiofrequency ablation lesions by CMR imaging after ablation of idiopathic ventricular arrhythmias. JACC. Cardiovascular Imaging, 3(3), 278-85. https://doi.org/10.1016/j.jcmg.2009.09.028
Ilg K, et al. Assessment of Radiofrequency Ablation Lesions By CMR Imaging After Ablation of Idiopathic Ventricular Arrhythmias. JACC Cardiovasc Imaging. 2010;3(3):278-85. PubMed PMID: 20223425.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of radiofrequency ablation lesions by CMR imaging after ablation of idiopathic ventricular arrhythmias. AU - Ilg,Karl, AU - Baman,Timir S, AU - Gupta,Sanjaya K, AU - Swanson,Scott, AU - Good,Eric, AU - Chugh,Aman, AU - Jongnarangsin,Krit, AU - Pelosi,Frank,Jr AU - Crawford,Thomas, AU - Oral,Hakan, AU - Morady,Fred, AU - Bogun,Frank, PY - 2009/09/01/received PY - 2009/09/22/accepted PY - 2010/3/13/entrez PY - 2010/3/13/pubmed PY - 2010/6/11/medline SP - 278 EP - 85 JF - JACC. Cardiovascular imaging JO - JACC Cardiovasc Imaging VL - 3 IS - 3 N2 - OBJECTIVES: To identify and characterize ablation lesions after radiofrequency (RF) catheter ablation of ventricular arrhythmias in patients without prior myocardial infarction and to correlate the ablation lesions with the amount of RF energy delivered and the clinical outcome. BACKGROUND: Visualization of RF energy lesions after ablation of ventricular arrhythmias might help to identify reasons for ablation failure. METHODS: In a consecutive series of 35 patients (19 women, age: 48 +/- 15 years, ejection fraction: 0.56 +/- 0.12) without structural heart disease who were referred for ablation of ventricular arrhythmias, cardiac magnetic resonance imaging with delayed enhancement was performed before and after ablation. Ablation lesions were sought in the post-ablation cardiac magnetic resonance images. The endocardial area, depth, and volume of the lesions were measured. Lesion size was correlated with the type of ablation catheter used and the duration of RF energy delivered. RESULTS: In 25 of 35 patients (71%), ablation lesions were identified by delayed enhancement a mean of 22 +/- 12 months after the initial ablation procedure. The mean lesion volume was 1.4 +/- 1.4 cm(3), with a mean endocardial area of 3.5 +/- 3.0 cm(2). The largest lesions (mean volume of 2.9 +/- 2.1 cm(3) with an endocardial area of 6.4 +/- 3.4 cm(2)) were identified in patients in whom the arrhythmias originated in the papillary muscles. Ablation duration correlated with lesion size (r = 0.67, p < 0.001). There was no difference in lesion volume with irrigated versus nonirrigated ablation catheters (1.0 +/- 0.73 vs. 2.0 +/- 2.1 cm(3), p = 0.09). Identification of ablation lesions in patients with a failed procedure identified the sites where ineffective RF energy lesions were created. CONCLUSIONS: RF ablation lesions can be detected long term after an ablation procedure targeting ventricular arrhythmias in patients without previous infarction. Lesion size correlates with the amount of RF energy delivered and is largest when a targeted arrhythmia originates in a papillary muscle. SN - 1876-7591 UR - https://www.unboundmedicine.com/medline/citation/20223425/Assessment_of_radiofrequency_ablation_lesions_by_CMR_imaging_after_ablation_of_idiopathic_ventricular_arrhythmias_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1936-878X(09)00855-9 DB - PRIME DP - Unbound Medicine ER -