Identification and acute targeting of gaps in atrial ablation lesion sets using a real-time magnetic resonance imaging system

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Publication Type pre-print
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Creator Macleod, Robert S.
Other Author Ranjan, Ravi; Kholmovski, Eugene G.; Blauer, Joshua; Vijayakumar, Sathya; Volland, Nelly A.; Salama, Mohamed E.; Parker, Dennis L.; Marrouche, Nassir F.
Title Identification and acute targeting of gaps in atrial ablation lesion sets using a real-time magnetic resonance imaging system
Date 2012-01-01
Description Background-Radiofrequency ablation is routinely used to treat cardiac arrhythmias, but gaps remain in ablation lesion sets because there is no direct visualization of ablation-related changes. In this study, we acutely identify and target gaps using a real-time magnetic resonance imaging (RT-MRI) system, leading to a complete and transmural ablation in the atrium. Methods and Results-A swine model was used for these studies (n=12). Ablation lesions with a gap were created in the atrium using fluoroscopy and an electroanatomic system in the first group (n=5). The animal was then moved to a 3-tesla MRI system where high-resolution late gadolinium enhancement MRI was used to identify the gap. Using an RT-MRI catheter navigation and visualization system, the gap area was ablated in the MR scanner. In a second group (n=7), ablation lesions with varying gaps in between were created under RT-MRI guidance, and gap lengths determined using late gadolinium enhancement MR images were correlated with gap length measured from gross pathology. Gaps up to 1.0 mm were identified using gross pathology, and gaps up to 1.4 mm were identified using late gadolinium enhancement MRI. Using an RT-MRI system with active catheter navigation gaps can be targeted acutely, leading to lesion sets with no gaps. The correlation coefficient (R2) between the gap length was identified using MRI, and the gross pathology was 0.95. Conclusions-RT-MRI system can be used to identify and acutely target gaps in atrial ablation lesion sets. Acute targeting of gaps in ablation lesion sets can potentially lead to significant improvement in clinical outcomes.
Type Text
Publisher American Heart Association
Volume 5
Issue 6
First Page 1130
Last Page 1135
Language eng
Bibliographic Citation Ranjan, R., Kholmovski, E. G., Blauer, J., Vijayakumar, S., Volland, N. A., Salama, M. E., Parker, D. L., MacLeod, R., & Marrouche, N. F. (2012). Identification and acute targeting of gaps in atrial ablation lesion sets using a real-time magnetic resonance imaging system. Circulation: Arrhythmia and Electrophysiology, 5(6), 1130-5.
Rights Management (c)American Heart Association http://www.ahajournals.org/
Format Medium application/pdf
Format Extent 802,508 bytes
Identifier uspace,18198
ARK ark:/87278/s6wm4ph9
Setname ir_uspace
Date Created 2014-05-12
Date Modified 2014-05-12
ID 712532
Reference URL https://collections.lib.utah.edu/ark:/87278/s6wm4ph9
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