PMID- 28245348 OWN - NLM STAT- MEDLINE DCOM- 20171218 LR - 20240213 IS - 1540-8167 (Electronic) IS - 1045-3873 (Print) IS - 1045-3873 (Linking) VI - 28 IP - 5 DP - 2017 May TI - Acute Cardiac MRI Assessment of Radiofrequency Ablation Lesions for Pediatric Ventricular Arrhythmia: Feasibility and Clinical Correlation. PG - 517-522 LID - 10.1111/jce.13197 [doi] AB - BACKGROUND: Arrhythmia ablation with current techniques is not universally successful. Inadequate ablation lesion formation may be responsible for some arrhythmia recurrences. Periprocedural visualization of ablation lesions may identify inadequate lesions and gaps to guide further ablation and reduce risk of arrhythmia recurrence. METHODS: This feasibility study assessed acute postprocedure ablation lesions by MRI, and correlated these findings with clinical outcomes. Ten pediatric patients who underwent ventricular tachycardia ablation were transferred immediately postablation to a 1.5T MRI scanner and late gadolinium enhancement (LGE) imaging was performed to characterize ablation lesions. Immediate and mid-term arrhythmia recurrences were assessed. RESULTS: Patient characteristics include median age 14 years (1-18 years), median weight 52 kg (11-81 kg), normal cardiac anatomy (n = 6), d-transposition of great arteries post arterial switch repair (n = 2), anomalous coronary artery origin post repair (n = 1), and cardiac rhabdomyoma (n = 1). All patients underwent radiofrequency catheter ablation of ventricular arrhythmia with acute procedural success. LGE was identified at the reported ablation site in 9/10 patients, all arrhythmia-free at median 7 months follow-up. LGE was not visible in 1 patient who had recurrence of frequent premature ventricular contractions within 2 hours, confirmed on Holter at 1 and 21 months post procedure. CONCLUSIONS: Ventricular ablation lesion visibility by MRI in the acute post procedure setting is feasible. Lesions identifiable with MRI may correlate with clinical outcomes. Acute MRI identification of gaps or inadequate lesions may provide the unique temporal opportunity for additional ablation therapy to decrease arrhythmia recurrence. CI - (c) 2017 Wiley Periodicals, Inc. FAU - Grant, Elena K AU - Grant EK AD - Department of Cardiology, Children's National Health System, Washington, District of Columbia, USA. AD - Division of Intramural Research, Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA. FAU - Berul, Charles I AU - Berul CI AD - Department of Cardiology, Children's National Health System, Washington, District of Columbia, USA. FAU - Cross, Russell R AU - Cross RR AD - Department of Cardiology, Children's National Health System, Washington, District of Columbia, USA. FAU - Moak, Jeffrey P AU - Moak JP AD - Department of Cardiology, Children's National Health System, Washington, District of Columbia, USA. FAU - Hamann, Karin S AU - Hamann KS AD - Department of Cardiology, Children's National Health System, Washington, District of Columbia, USA. FAU - Sumihara, Kohei AU - Sumihara K AD - Department of Cardiology, Children's National Health System, Washington, District of Columbia, USA. FAU - Cronin, Ileen AU - Cronin I AD - Department of Cardiology, Children's National Health System, Washington, District of Columbia, USA. FAU - O'Brien, Kendall J AU - O'Brien KJ AD - Department of Cardiology, Children's National Health System, Washington, District of Columbia, USA. FAU - Ratnayaka, Kanishka AU - Ratnayaka K AD - Division of Intramural Research, Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA. AD - Department of Cardiology, Rady Children's Hospital, San Diego, California, USA. FAU - Hansen, Michael S AU - Hansen MS AD - Department of Cardiology, Children's National Health System, Washington, District of Columbia, USA. AD - Division of Intramural Research, Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA. FAU - Kellman, Peter AU - Kellman P AD - Department of Cardiology, Children's National Health System, Washington, District of Columbia, USA. AD - Division of Intramural Research, Cardiovascular and Pulmonary Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA. FAU - Olivieri, Laura J AU - Olivieri LJ AD - Department of Cardiology, Children's National Health System, Washington, District of Columbia, USA. LA - eng GR - HHSN268201500001C/HL/NHLBI NIH HHS/United States GR - HHSN268201500001I/HL/NHLBI NIH HHS/United States PT - Journal Article DEP - 20170328 PL - United States TA - J Cardiovasc Electrophysiol JT - Journal of cardiovascular electrophysiology JID - 9010756 SB - IM MH - Adolescent MH - Age Factors MH - *Catheter Ablation/adverse effects MH - Child MH - Child, Preschool MH - Feasibility Studies MH - Female MH - Heart Ventricles/diagnostic imaging/pathology/physiopathology/*surgery MH - Humans MH - Infant MH - *Magnetic Resonance Imaging MH - Male MH - Predictive Value of Tests MH - Prospective Studies MH - Recurrence MH - Risk Factors MH - Tachycardia, Ventricular/diagnostic imaging/physiopathology/*surgery MH - Time Factors MH - Treatment Outcome PMC - PMC5444970 MID - NIHMS856095 OTO - NOTNLM OT - ablation OT - arrhythmia OT - congenital heart disease OT - electrophysiology OT - magnetic resonance imaging EDAT- 2017/03/01 06:00 MHDA- 2017/12/19 06:00 PMCR- 2018/05/01 CRDT- 2017/03/01 06:00 PHST- 2016/11/28 00:00 [received] PHST- 2016/12/28 00:00 [revised] PHST- 2017/01/18 00:00 [accepted] PHST- 2017/03/01 06:00 [pubmed] PHST- 2017/12/19 06:00 [medline] PHST- 2017/03/01 06:00 [entrez] PHST- 2018/05/01 00:00 [pmc-release] AID - 10.1111/jce.13197 [doi] PST - ppublish SO - J Cardiovasc Electrophysiol. 2017 May;28(5):517-522. doi: 10.1111/jce.13197. Epub 2017 Mar 28.