PMID- 32428229 OWN - NLM STAT- MEDLINE DCOM- 20210625 LR - 20220531 IS - 1532-2092 (Electronic) IS - 1099-5129 (Linking) VI - 22 IP - 7 DP - 2020 Jul 1 TI - Correlation of magnetic resonance imaging and post-ablation endoscopy to detect oesophageal thermal injury in patients after atrial fibrillation ablation: MRI-EDEL-study. PG - 1009-1016 LID - 10.1093/europace/euaa081 [doi] AB - AIMS: To correlate oesophageal magnetic resonance imaging (MRI) abnormalities with ablation-induced oesophageal injury detected in endoscopy. METHODS AND RESULTS: Ablation-naive patients with atrial fibrillation (AF), who underwent ablation using a contact force sensing irrigated radiofrequency ablation catheter, received a cardiac MRI on the day of ablation, and post-ablation oesophageal endoscopy (OE) 1 day after ablation. Two MRI expert readers recorded presence of abnormal oesophageal tissue signal intensities, defined as increased oesophageal signal in T2-fat-saturated (T2fs), short-tau inversion-recovery (STIR), or late gadolinium enhancement (LGE) sequences. Oesophageal endoscopy was performed by experienced operators. Finally, we correlated the presence of any affection with endoscopically detected oesophageal thermal lesions (EDEL). Among 50 consecutive patients (age 67 +/- 7 years, 60% male), who received post-ablation MRI and OE, complete MRI data were available in 44 of 50 (88%) patients. In OE, 7 of 50 (14%) presented with EDEL (Category 1 lesion: erosion n = 3, Category 2 lesion: ulcer n = 4). Among those with EDEL, 6 of 7 (86%) patients presented with increased signal intensities in all three MRI sequences, while only 2 of 37 (5%) showed hyperintensities in all three MRI sequences and negative endoscopy. Correspondingly, sensitivity, specificity, positive predictive value, and negative predictive value (NPV) for MRI (increased signal in T2fs, STIR, and LGE) were 86%, 95%, 75%, and 97%, respectively. CONCLUSION: Increased signal intensity in T2fs, STIR, and LGE represents independent markers of EDEL. In particular, the combination of all three has the highest diagnostic value. Hence, MRI may represent an accurate, non-invasive method to exclude acute oesophageal injury after AF ablation (NPV: 97%). CI - Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author(s) 2020. For permissions, please email: journals.permissions@oup.com. FAU - Halbfass, Philipp AU - Halbfass P AD - Clinic for Invasive Electrophysiology, Rhon-Klinikum Campus Bad Neustadt, Von-Guttenberg-Strasse 11, 97616 Bad Neustadt a.d. Saale, Germany. AD - Department of Cardiology and Angiology, Philipps-University Marburg, Marburg, Germany. FAU - Lehmkuhl, Lukas AU - Lehmkuhl L AD - Clinic for Radiology, Rhon-Klinikum Campus Bad Neustadt, Bad Neustadt a.d. Saale, Germany. FAU - Foldyna, Borek AU - Foldyna B AD - Clinic for Radiology, Rhon-Klinikum Campus Bad Neustadt, Bad Neustadt a.d. Saale, Germany. AD - Cardiovascular Imaging Research Center, Massachusetts General Hospital - Harvard Medical School, Boston, USA. FAU - Berkovitz, Artur AU - Berkovitz A AD - Clinic for Invasive Electrophysiology, Rhon-Klinikum Campus Bad Neustadt, Von-Guttenberg-Strasse 11, 97616 Bad Neustadt a.d. Saale, Germany. FAU - Sonne, Kai AU - Sonne K AD - Clinic for Invasive Electrophysiology, Rhon-Klinikum Campus Bad Neustadt, Von-Guttenberg-Strasse 11, 97616 Bad Neustadt a.d. Saale, Germany. FAU - Nentwich, Karin AU - Nentwich K AD - Clinic for Invasive Electrophysiology, Rhon-Klinikum Campus Bad Neustadt, Von-Guttenberg-Strasse 11, 97616 Bad Neustadt a.d. Saale, Germany. FAU - Ene, Elena AU - Ene E AD - Clinic for Invasive Electrophysiology, Rhon-Klinikum Campus Bad Neustadt, Von-Guttenberg-Strasse 11, 97616 Bad Neustadt a.d. Saale, Germany. FAU - Fochler, Franziska AU - Fochler F AD - Clinic for Invasive Electrophysiology, Rhon-Klinikum Campus Bad Neustadt, Von-Guttenberg-Strasse 11, 97616 Bad Neustadt a.d. Saale, Germany. FAU - Horning, Frank AU - Horning F AD - Department of Internal Medicine, Rhon-Klinikum Campus Bad Neustadt, Bad Neustadt a.d. Saale, Germany. FAU - Matveeva, Anna AU - Matveeva A AD - Clinic for Radiology, Rhon-Klinikum Campus Bad Neustadt, Bad Neustadt a.d. Saale, Germany. FAU - Lusebrink, Ulrich AU - Lusebrink U AD - Department of Cardiology and Angiology, Philipps-University Marburg, Marburg, Germany. FAU - Deneke, Thomas AU - Deneke T AD - Clinic for Invasive Electrophysiology, Rhon-Klinikum Campus Bad Neustadt, Von-Guttenberg-Strasse 11, 97616 Bad Neustadt a.d. Saale, Germany. LA - eng PT - Journal Article PL - England TA - Europace JT - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology JID - 100883649 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) SB - IM MH - Aged MH - *Atrial Fibrillation/diagnostic imaging/surgery MH - *Catheter Ablation/adverse effects MH - Contrast Media MH - Esophagoscopy MH - Esophagus/*injuries MH - Female MH - Gadolinium MH - Heart Atria/surgery MH - Humans MH - Magnetic Resonance Imaging MH - Male MH - Middle Aged OTO - NOTNLM OT - Atrial fibrillation OT - Endoscopically detected oesophageal lesion OT - Late gadolinium enhancement magnetic resonance imaging OT - Oesophageal lesion EDAT- 2020/05/20 06:00 MHDA- 2021/06/29 06:00 CRDT- 2020/05/20 06:00 PHST- 2019/11/13 00:00 [received] PHST- 2020/03/24 00:00 [accepted] PHST- 2020/05/20 06:00 [pubmed] PHST- 2021/06/29 06:00 [medline] PHST- 2020/05/20 06:00 [entrez] AID - 5840665 [pii] AID - 10.1093/europace/euaa081 [doi] PST - ppublish SO - Europace. 2020 Jul 1;22(7):1009-1016. doi: 10.1093/europace/euaa081.