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Characterization of edema after cryo and radiofrequency ablations based on serial magnetic resonance imaging.
J Cardiovasc Electrophysiol. 2019 02; 30(2):255-262.JC

Abstract

INTRODUCTION

Radiofrequency (RF) and cryoablation are routinely used to treat arrhythmias, but the extent and time course of edema associated with the two different modalities is unknown. Our goal was to follow the lesion maturation and edema formation after RF and cryoablation using serial magnetic resonance imaging (MRI).

METHODS AND RESULTS

Ventricular ablation was performed in a canine model (n = 11) using a cryo or an irrigated RF catheter. T2-weighted (T2w) edema imaging and late gadolinium enhancement (LGE)-MRI were done immediately (0 day: acute), 1 to 2 weeks (subacute), and 8 to 12 weeks (chronic) after ablation. After the final MRI, excised hearts underwent pathological evaluation. As a result, 45 ventricular lesions (cryo group: 20; RF group: 25) were evaluated. Acute LGE volume was not significantly different but acute edema volume in cryo group was significantly smaller (1225.0 ± 263.5 vs 1855.2 ± 520.5 mm3 ; P = 0.01). One week after ablation, edema still existed in both group but was similar in size. Two weeks after ablation there was no edema in either of the groups. In the chronic phase, the lesion volume for cryo and RF in LGE-MRI (296.7 ± 156.4 vs 281.6 ± 140.8 mm3 ; P = 0.73); and pathology (243.3 ± 125.9 vs 214.5 ± 148.6 mm3 ; P = 0.49), as well as depth, was comparable.

CONCLUSIONS

When comparing cryo and RF lesions of similar chronic size, acute edema is larger for RF lesions. Edema resolves in both cryo and RF lesions in 1 to 2 weeks.

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Authors+Show Affiliations

Yamashita K
Department of Medicine, Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah. Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah.
Kholmovski E
Department of Radiology and Imaging Sciences, UCAIR, University of Utah, Salt Lake City, Utah. CARMA Center, Department of Medicine, Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah.
Ghafoori E
Department of Medicine, Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah. Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah. Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah.
Kamali R
Department of Medicine, Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah. Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah. Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah.
Kwan E
Department of Medicine, Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah. Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah. Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah.
Lichter J
Department of Medicine, Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah. Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah.
MacLeod R
Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah. Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah.
Dosdall DJ
Department of Medicine, Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah. Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah. Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah. Department of Surgery, Division of Cardiothoracic Surgery, University of Utah, Salt Lake City, Utah.
Ranjan R
Department of Medicine, Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah. Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah. Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah.

MeSH

AnimalsContrast MediaCryosurgeryDogsEdema, CardiacHeart VentriclesMagnetic Resonance ImagingMeglumineMyocardiumOrganometallic CompoundsPredictive Value of TestsRadiofrequency AblationTime Factors

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30375090

Citation

Yamashita, Kennosuke, et al. "Characterization of Edema After Cryo and Radiofrequency Ablations Based On Serial Magnetic Resonance Imaging." Journal of Cardiovascular Electrophysiology, vol. 30, no. 2, 2019, pp. 255-262.
Yamashita K, Kholmovski E, Ghafoori E, et al. Characterization of edema after cryo and radiofrequency ablations based on serial magnetic resonance imaging. J Cardiovasc Electrophysiol. 2019;30(2):255-262.
Yamashita, K., Kholmovski, E., Ghafoori, E., Kamali, R., Kwan, E., Lichter, J., MacLeod, R., Dosdall, D. J., & Ranjan, R. (2019). Characterization of edema after cryo and radiofrequency ablations based on serial magnetic resonance imaging. Journal of Cardiovascular Electrophysiology, 30(2), 255-262. https://doi.org/10.1111/jce.13785
Yamashita K, et al. Characterization of Edema After Cryo and Radiofrequency Ablations Based On Serial Magnetic Resonance Imaging. J Cardiovasc Electrophysiol. 2019;30(2):255-262. PubMed PMID: 30375090.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characterization of edema after cryo and radiofrequency ablations based on serial magnetic resonance imaging. AU - Yamashita,Kennosuke, AU - Kholmovski,Eugene, AU - Ghafoori,Elyar, AU - Kamali,Roya, AU - Kwan,Eugene, AU - Lichter,Justin, AU - MacLeod,Robert, AU - Dosdall,Derek J, AU - Ranjan,Ravi, Y1 - 2018/11/21/ PY - 2018/09/05/received PY - 2018/10/16/revised PY - 2018/10/23/accepted PY - 2018/10/31/pubmed PY - 2020/3/13/medline PY - 2018/10/31/entrez KW - catheter ablation KW - cryoablation KW - late gadolinium enhancement KW - magnetic resonance imaging KW - radiofrequency SP - 255 EP - 262 JF - Journal of cardiovascular electrophysiology JO - J Cardiovasc Electrophysiol VL - 30 IS - 2 N2 - INTRODUCTION: Radiofrequency (RF) and cryoablation are routinely used to treat arrhythmias, but the extent and time course of edema associated with the two different modalities is unknown. Our goal was to follow the lesion maturation and edema formation after RF and cryoablation using serial magnetic resonance imaging (MRI). METHODS AND RESULTS: Ventricular ablation was performed in a canine model (n = 11) using a cryo or an irrigated RF catheter. T2-weighted (T2w) edema imaging and late gadolinium enhancement (LGE)-MRI were done immediately (0 day: acute), 1 to 2 weeks (subacute), and 8 to 12 weeks (chronic) after ablation. After the final MRI, excised hearts underwent pathological evaluation. As a result, 45 ventricular lesions (cryo group: 20; RF group: 25) were evaluated. Acute LGE volume was not significantly different but acute edema volume in cryo group was significantly smaller (1225.0 ± 263.5 vs 1855.2 ± 520.5 mm3 ; P = 0.01). One week after ablation, edema still existed in both group but was similar in size. Two weeks after ablation there was no edema in either of the groups. In the chronic phase, the lesion volume for cryo and RF in LGE-MRI (296.7 ± 156.4 vs 281.6 ± 140.8 mm3 ; P = 0.73); and pathology (243.3 ± 125.9 vs 214.5 ± 148.6 mm3 ; P = 0.49), as well as depth, was comparable. CONCLUSIONS: When comparing cryo and RF lesions of similar chronic size, acute edema is larger for RF lesions. Edema resolves in both cryo and RF lesions in 1 to 2 weeks. SN - 1540-8167 UR - https://www.unboundmedicine.com/medline/citation/30375090/Characterization_of_edema_after_cryo_and_radiofrequency_ablations_based_on_serial_magnetic_resonance_imaging_ DB - PRIME DP - Unbound Medicine ER -