Visualization of the radiofrequency lesion after pulmonary vein isolation using delayed enhancement magnetic resonance imaging fused with magnetic resonance angiography.

Abstract

BACKGROUND: The radiofrequency (RF) lesions for atrial fibrillation (AF) ablation can be visualized by delayed enhancement magnetic resonance imaging (DE-MRI). However, the quality of anatomical information provided by DE-MRI is not adequate due to its spatial resolution. In contrast, magnetic resonance angiography (MRA) provides similar information regarding the left atrium (LA) and pulmonary veins (PVs) as computed tomography angiography. We hypothesized that DE-MRI fused with MRA will compensate for the inadequate image quality provided by DE-MRI. METHODS: DE-MRI and MRA were performed in 18 patients who underwent AF ablation (age, 60±9 years; LA diameter, 42±6 mm). Two observers independently assessed the DE-MRI and DE-MRI fused with MRA for visualization of the RF lesion (score 0-2; where 0: not visualized and 2: excellent in all 14 segments of the circular RF lesion). RESULTS: DE-MRI fused with MRA was successfully performed in all patients. The image quality score was significantly higher in DE-MRI fused with MRA compared to DE-MRI alone (observer 1: 22 (18, 25) vs 28 (28, 28), p<0.001; observer 2: 24 (23, 25) vs 28 (28, 28), p<0.001). CONCLUSIONS: DE-MRI fused with MRA was superior to DE-MRI for visualization of the RF lesion owing to the precise information on LA and PV anatomy provided by DE-MRI.

AI evidence extraction

Main findings

In 18 post-ablation patients, DE-MRI fused with MRA was successfully performed in all cases and produced significantly higher image quality scores for RF lesion visualization than DE-MRI alone for both observers (p<0.001).

Outcomes measured

• Visualization/image quality of radiofrequency lesion on delayed enhancement MRI (DE-MRI) vs DE-MRI fused with magnetic resonance angiography (MRA)
• Image quality score (0–2 per segment; summed across 14 segments)

Limitations

• Small sample size (n=18)
• Outcome focused on imaging visualization/quality rather than health effects
• No radiofrequency exposure parameters (e.g., frequency, power, duration) reported

{
    "study_type": "other",
    "exposure": {
        "band": null,
        "source": "radiofrequency ablation (cardiac)",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": null
    },
    "population": "Patients who underwent atrial fibrillation ablation",
    "sample_size": 18,
    "outcomes": [
        "Visualization/image quality of radiofrequency lesion on delayed enhancement MRI (DE-MRI) vs DE-MRI fused with magnetic resonance angiography (MRA)",
        "Image quality score (0–2 per segment; summed across 14 segments)"
    ],
    "main_findings": "In 18 post-ablation patients, DE-MRI fused with MRA was successfully performed in all cases and produced significantly higher image quality scores for RF lesion visualization than DE-MRI alone for both observers (p<0.001).",
    "effect_direction": "unclear",
    "limitations": [
        "Small sample size (n=18)",
        "Outcome focused on imaging visualization/quality rather than health effects",
        "No radiofrequency exposure parameters (e.g., frequency, power, duration) reported"
    ],
    "evidence_strength": "low",
    "confidence": 0.7399999999999999911182158029987476766109466552734375,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "radiofrequency lesion",
        "atrial fibrillation",
        "pulmonary vein isolation",
        "delayed enhancement MRI",
        "magnetic resonance angiography",
        "image fusion"
    ],
    "suggested_hubs": []
}

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