PMID- 23293924
OWN - NLM
STAT- MEDLINE
DCOM- 20130930
LR  - 20220408
IS  - 1540-8167 (Electronic)
IS  - 1045-3873 (Linking)
VI  - 24
IP  - 4
DP  - 2013 Apr
TI  - Diagnostic accuracy of cardiac magnetic resonance imaging in the detection and 
      characterization of left atrial catheter ablation lesions: a multicenter 
      experience.
PG  - 396-403
LID - 10.1111/jce.12063 [doi]
AB  - INTRODUCTION: We tested the hypothesis that cardiovascular magnetic resonance 
      (CMR) imaging can reliably distinguish the presence or absence of left atrial 
      (LA) ablation lesions by blinded analysis of pre- and postablation imaging. 
      METHODS: Consecutive patients at 2 centers undergoing pulmonary vein isolation 
      (PVI) for paroxysmal atrial fibrillation by either wide area circumferential 
      radiofrequency ablation (WACA) or ostial ablation with a cryoballoon underwent 
      CMR late gadolinium enhancement (LGE) imaging pre- and 3 months postablation. 
      Imaging was anonymized for blinded analysis of (1) LGE images, and (2) a 3D 
      fusion image with LGE projected onto a segmented LA surface. Scans were 
      categorized using both assessment techniques separately as pre- or postablation, 
      and if postablation, whether lesions were in an ostial or WACA distribution. 
      RESULTS: LGE imaging was performed in 50 patients (aged 60 +/- 10 years, 68% male, 
      24 underwent WACA and 26 had cryoablation). Sensitivity and specificity for 
      detection of ablation lesions was 60% and 96% on LGE imaging. Sensitivity was 
      higher using 3D fusion imaging (88%; P = 0.003). The proportion in whom lesions 
      were both detected and the distribution correctly assessed as WACA or ostial was 
      higher with 3D fusion imaging compared to LGE imaging (54% vs 28%; P = 0.014). 
      There was no difference in the detection of radiofrequency ablation lesions 
      compared to cryoablation lesions (58% vs 62%; P = 1.000). CONCLUSION: LGE imaging 
      of atrial scar is not yet sufficiently accurate to reliably identify ablation 
      lesions or to determine lesion distribution.
CI  - (c) 2013 Wiley Periodicals, Inc.
FAU - Hunter, Ross J
AU  - Hunter RJ
AD  - Barts and The London NIHR Cardiovascular Biomedical Research Unit, William Harvey 
      Research Institute, Queen Mary, University of London, London, UK.
FAU - Jones, Daniel A
AU  - Jones DA
FAU - Boubertakh, Redha
AU  - Boubertakh R
FAU - Malcolme-Lawes, Louisa C
AU  - Malcolme-Lawes LC
FAU - Kanagaratnam, Prapa
AU  - Kanagaratnam P
FAU - Juli, Christoph F
AU  - Juli CF
FAU - Davies, D Wyn
AU  - Davies DW
FAU - Peters, Nicholas S
AU  - Peters NS
FAU - Baker, Victoria
AU  - Baker V
FAU - Earley, Mark J
AU  - Earley MJ
FAU - Sporton, Simon
AU  - Sporton S
FAU - Davies, L Ceri
AU  - Davies LC
FAU - Westwood, Mark
AU  - Westwood M
FAU - Petersen, Steffen E
AU  - Petersen SE
FAU - Schilling, Richard J
AU  - Schilling RJ
LA  - eng
GR  - PG/10/37/28347/BHF_/British Heart Foundation/United Kingdom
GR  - RG/10/11/28457/BHF_/British Heart Foundation/United Kingdom
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20130107
PL  - United States
TA  - J Cardiovasc Electrophysiol
JT  - Journal of cardiovascular electrophysiology
JID - 9010756
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Aged
MH  - Atrial Fibrillation/pathology/*surgery
MH  - *Catheter Ablation/adverse effects
MH  - Chi-Square Distribution
MH  - Cicatrix/etiology/*pathology
MH  - Contrast Media
MH  - *Cryosurgery/adverse effects
MH  - Female
MH  - Gadolinium DTPA
MH  - Heart Atria/pathology/surgery
MH  - Humans
MH  - Image Interpretation, Computer-Assisted
MH  - Imaging, Three-Dimensional
MH  - Logistic Models
MH  - London
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Observer Variation
MH  - Odds Ratio
MH  - Predictive Value of Tests
MH  - Pulmonary Veins/pathology/*surgery
MH  - Reproducibility of Results
MH  - Treatment Outcome
EDAT- 2013/01/09 06:00
MHDA- 2013/10/01 06:00
CRDT- 2013/01/09 06:00
PHST- 2013/01/09 06:00 [entrez]
PHST- 2013/01/09 06:00 [pubmed]
PHST- 2013/10/01 06:00 [medline]
AID - 10.1111/jce.12063 [doi]
PST - ppublish
SO  - J Cardiovasc Electrophysiol. 2013 Apr;24(4):396-403. doi: 10.1111/jce.12063. Epub 
      2013 Jan 7.