PMID- 25251403
OWN - NLM
STAT- MEDLINE
DCOM- 20150623
LR  - 20211021
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 9
IP  - 9
DP  - 2014
TI  - Cardiovascular magnetic resonance imaging of scar development following pulmonary 
      vein isolation: a prospective study.
PG  - e104844
LID - 10.1371/journal.pone.0104844 [doi]
LID - e104844
AB  - AIMS: Cardiovascular magnetic resonance (MR) provides non-invasive assessment of 
      early (24-hour) edema and injury following pulmonary vein isolation (by ablation) 
      and subsequent scar formation. We hypothesize that 24-hours after ablation, 
      cardiovascular MR would demonstrate a pattern of edema and injury due to ablation 
      and the severity would correlate with subsequent scar. METHODS: Fifteen atrial 
      fibrillation patients underwent cardiovascular MR prior to pulmonary vein 
      isolation, 24-hours post (N = 11) and 30-days post (N = 7) ablation, with 
      T2-weighted (T2W) and late gadolinium enhancement (LGE) imaging. Left atrial wall 
      thickness, edema enhancement ratio and LGE enhancement were assessed at each time 
      point. Volumes of LGE and edema enhancement were measured, and the 
      circumferential presence of injury was assessed at 24-hours, including comparison 
      with LGE enhancement at 30 days. RESULTS: Left atrial wall thickness was 
      increased 24-hours post-ablation (10.7 +/- 4.1 mm vs. 7.0 +/- 1.8 mm pre-PVI, 
      p<0.05). T2W enhancement at 24-hours showed increased edema enhancement ratio 
      (1.5 +/- 0.4 for post-ablation, vs. 0.9 +/- 0.2 pre-ablation, p < 0.001). Edema and 
      LGE volumes at 24-hours were correlated with 30-day LGE volume (R = 0.76, p = 
      0.04, and R = 0.74, p = 0.09, respectively). Using a 16 segment model for 
      assessment, 24-hour T2W had sensitivity, specificity, and accuracy of 82%, 63%, 
      and 79% respectively, for predicting 30-day LGE. 24-hour LGE had sensitivity, 
      specificity, and accuracy of 91%, 47%, and 84%. CONCLUSIONS: Increased left 
      atrial wall thickening and edema were characterized on cardiovascular MR early 
      post-ablation, and found to correlate with 30-day LGE scar.
FAU - Hsing, Jeff
AU  - Hsing J
AD  - Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical 
      Center, Harvard Medical School, Boston, Massachusetts, United States of America.
FAU - Peters, Dana C
AU  - Peters DC
AD  - Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical 
      Center, Harvard Medical School, Boston, Massachusetts, United States of America; 
      Department of Radiology, Yale Medical School, New Haven, Connecticut, United 
      States of America.
FAU - Knowles, Benjamin R
AU  - Knowles BR
AD  - Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical 
      Center, Harvard Medical School, Boston, Massachusetts, United States of America.
FAU - Manning, Warren J
AU  - Manning WJ
AD  - Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical 
      Center, Harvard Medical School, Boston, Massachusetts, United States of America; 
      Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical 
      School, Boston, Massachusetts, United States of America.
FAU - Josephson, Mark E
AU  - Josephson ME
AD  - Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical 
      Center, Harvard Medical School, Boston, Massachusetts, United States of America.
LA  - eng
GR  - R21 HL098573/HL/NHLBI NIH HHS/United States
GR  - R21 HL103463/HL/NHLBI NIH HHS/United States
GR  - R21 HL 098573/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20140924
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Adult
MH  - Atrial Fibrillation/*therapy
MH  - Cardiovascular System/diagnostic imaging/pathology
MH  - Catheter Ablation/adverse effects/*methods
MH  - Cicatrix/*diagnosis/diagnostic imaging/etiology
MH  - Contrast Media
MH  - Edema/diagnosis/diagnostic imaging/etiology
MH  - Female
MH  - Gadolinium DTPA
MH  - Humans
MH  - Image Enhancement/methods
MH  - Linear Models
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Pulmonary Veins/diagnostic imaging/*pathology
MH  - Radiography
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Time Factors
PMC - PMC4174508
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2014/09/25 06:00
MHDA- 2015/06/24 06:00
PMCR- 2014/09/24
CRDT- 2014/09/25 06:00
PHST- 2014/03/26 00:00 [received]
PHST- 2014/07/17 00:00 [accepted]
PHST- 2014/09/25 06:00 [entrez]
PHST- 2014/09/25 06:00 [pubmed]
PHST- 2015/06/24 06:00 [medline]
PHST- 2014/09/24 00:00 [pmc-release]
AID - PONE-D-14-13387 [pii]
AID - 10.1371/journal.pone.0104844 [doi]
PST - epublish
SO  - PLoS One. 2014 Sep 24;9(9):e104844. doi: 10.1371/journal.pone.0104844. 
      eCollection 2014.