PMID- 32052461 OWN - NLM STAT- MEDLINE DCOM- 20210315 LR - 20210315 IS - 1540-8159 (Electronic) IS - 0147-8389 (Linking) VI - 43 IP - 3 DP - 2020 Mar TI - Ventricular arrhythmia ablation lesions detectability and temporal changes on cardiac magnetic resonance. PG - 314-321 LID - 10.1111/pace.13886 [doi] AB - BACKGROUND: Cardiac magnetic resonance (CMR) characteristics of ventricular radiofrequency ablation (RFA) lesions have only been incompletely defined. AIM: To determine the detectability and imaging characteristics of ventricular RFA lesions in an unselected patient cohort undergoing ventricular arrhythmia ablation. METHODS AND RESULTS: A retrospective chart review (n = 249) identified 36 patients with either pre-/postablation CMR (n = 14) or only postablation CMR (n = 22). Ablation lesions could be identified in 50% (n = 18) of patients. Nonvisualized lesions had more preexisting transmural late gadolinium enhancement (LGE) >75% at the ablation sites (21% vs 0.0%, P = .042), more prevalent ICD artifact (50% vs 0%, P = .001), and lower ejection fraction (35.8 +/- 14.2% vs 45.3 +/- 13.4%, P = .048). Early CMR imaging demonstrated a central "black" signal void (microvascular obstruction [MVO], n = 12, 67%) up to 32 days post-RFA, whereas late imaging showed a homogenously "white" gadolinium enhancement pattern (n = 6, 33%). MVO was only observed in nonfibrotic myocardium without preexisting LGE (n = 12) but was not observed in the scar with preexisting LGE (n = 3, P = .002) suggesting different wash-in/wash-out kinetics in scar/nonscar myocardium. Signal intensity (1909 vs 2534, P = .009) and contrast-to-noise ratio (-7.8 vs 16.3, P = .009) were significantly different between MVO and LGE lesions, respectively. CONCLUSION: Ventricular ablation lesions visualization is negatively affected by preexisting transmural scar, ICD artifact, and low ejection fraction. The transition of "black" MVO appearance to "white" LGE appearance on CMR occurs around 1 month following ablation, suggesting a change in histological characteristics of ablation lesions. This may affect the utility of CMR in the evaluation of the ventricular lesions, when undergoing real-time or repeat VT ablations. CI - (c) 2020 Wiley Periodicals, Inc. FAU - Vunnam, Rama AU - Vunnam R AUID- ORCID: 0000-0001-9431-7997 AD - Maryland Arrhythmia and Cardiology Imaging Group, Baltimore, Maryland. AD - Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland. FAU - Maheshwari, Varun AU - Maheshwari V AD - Maryland Arrhythmia and Cardiology Imaging Group, Baltimore, Maryland. AD - Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland. FAU - Jeudy, Jean AU - Jeudy J AD - Maryland Arrhythmia and Cardiology Imaging Group, Baltimore, Maryland. AD - Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland. FAU - Ghzally, Yousra AU - Ghzally Y AD - Maryland Arrhythmia and Cardiology Imaging Group, Baltimore, Maryland. AD - Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland. FAU - Imanli, Hasan AU - Imanli H AUID- ORCID: 0000-0001-6806-4463 AD - Maryland Arrhythmia and Cardiology Imaging Group, Baltimore, Maryland. AD - Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland. FAU - Abdulghani, Mohammed AU - Abdulghani M AD - Maryland Arrhythmia and Cardiology Imaging Group, Baltimore, Maryland. AD - Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland. FAU - Mahat, Jagat B AU - Mahat JB AD - Maryland Arrhythmia and Cardiology Imaging Group, Baltimore, Maryland. AD - Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland. FAU - Timilsina, Saroj AU - Timilsina S AD - Maryland Arrhythmia and Cardiology Imaging Group, Baltimore, Maryland. AD - Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland. FAU - Restrepo, Alejandro AU - Restrepo A AD - Maryland Arrhythmia and Cardiology Imaging Group, Baltimore, Maryland. AD - Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland. FAU - See, Vincent AU - See V AD - Maryland Arrhythmia and Cardiology Imaging Group, Baltimore, Maryland. AD - Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland. FAU - Shorofsky, Stephen AU - Shorofsky S AD - Maryland Arrhythmia and Cardiology Imaging Group, Baltimore, Maryland. AD - Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland. FAU - Dickfeld, Timm AU - Dickfeld T AD - Maryland Arrhythmia and Cardiology Imaging Group, Baltimore, Maryland. AD - Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland. LA - eng PT - Journal Article DEP - 20200306 PL - United States TA - Pacing Clin Electrophysiol JT - Pacing and clinical electrophysiology : PACE JID - 7803944 RN - 0 (Contrast Media) RN - 0 (Organometallic Compounds) RN - 15G12L5X8K (gadobenic acid) RN - 6HG8UB2MUY (Meglumine) SB - IM MH - *Catheter Ablation MH - Contrast Media MH - Electrophysiologic Techniques, Cardiac MH - Female MH - Humans MH - Magnetic Resonance Imaging, Cine/*methods MH - Male MH - Meglumine/analogs & derivatives MH - Middle Aged MH - Organometallic Compounds MH - Retrospective Studies MH - Tachycardia, Ventricular/*diagnostic imaging/physiopathology/*surgery MH - Ventricular Premature Complexes/*diagnostic imaging/physiopathology/*surgery OTO - NOTNLM OT - ablation OT - cardiac magnetic resonance OT - ventricular arrhythmia EDAT- 2020/02/14 06:00 MHDA- 2021/03/16 06:00 CRDT- 2020/02/14 06:00 PHST- 2019/09/30 00:00 [received] PHST- 2020/01/09 00:00 [revised] PHST- 2020/02/03 00:00 [accepted] PHST- 2020/02/14 06:00 [pubmed] PHST- 2021/03/16 06:00 [medline] PHST- 2020/02/14 06:00 [entrez] AID - 10.1111/pace.13886 [doi] PST - ppublish SO - Pacing Clin Electrophysiol. 2020 Mar;43(3):314-321. doi: 10.1111/pace.13886. Epub 2020 Mar 6.