Cardiac MRI allows evaluation of different ablation techniques in patients undergoing pulmonary vein ablation
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BioMed Central
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Poster presentation
Cardiac MRI allows evaluation of different ablation techniques in patients undergoing pulmonary vein ablation Christian Mahnkopf*, Martin Schmidt, Guido Ritscher, Harald Marschang, Manfred Dücker, Aben Sallam, Axel Jakob, Johannes Brachmann and Anil M Sinha Address: Klinikum Coburg, Coburg, Germany * Corresponding author
from 13th Annual SCMR Scientific Sessions Phoenix, AZ, USA. 21-24 January 2010 Published: 21 January 2010 Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):P55
doi:10.1186/1532-429X-12-S1-P55
Abstracts of the 13th Annual SCMR Scientific Sessions - 2010
Meeting abstracts - A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-infoThis abstract is available from: http://jcmr-online.com/content/12/S1/P55 © 2010 Mahnkopf et al; licensee BioMed Central Ltd.
Background
Summary
Pulmonary vein antrum isolation (PVAI) is regarded as an alternative therapy in atrial fibrillation (AF) patients. Dreaded complications of PVAI are pulmonary vein stenoses, which might be influenced by the applied ablation technique and material. Cardiac magnetic resonance imaging (CMR) has been introduced as a new tool for evaluation of ablation results.
Patients undergoing RFA suffered from reversible pulmonary vein stenosis by edema of the tissue, pulmonary congestion and pleural effusion, wheras patients undergoing CBA seemed to have no relevant deterioration early after PVAI. The choice of ablation technique and material seemed to determine the occurrence of complications, which could be reliably detected and evaluated by CMR. Thus, CMR might be used for evaluation of different ablation techniques in patients undergoing PVAI.
Methods 20 patients (14 male, 63,1 ± 9,1 y) with paroxysmal AF were included. 10 patients underwent PVAI with radiofrequency ablation (RFA), whereas the others received ablation with Cryoballoon (CBA). All patients were scheduled for CMR (Espree 1.5 T, Siemens, Germany) before, acute, and 24 hours after PVI. For pulmonary veins, cross sectional diameter, angiography of pulmonary veins and flow measurements of the right inferior pulmonary vein (RIPV) were performed.
Results In RFA patients, RIPV diameters signifcantly decreased during, and re-increased 24 h after PVI. RIPV blood flow significantly increased during, and slightly increased after intervention (Table 1). Also, pulmonary congestion and pleural effusion, which occurred acutely during PVI were recurrent after 24 h. Patients undergoing PVAI with Cryoballoon has no significant changes in parametes or signs of deterioration. Page 1 of 2 (page number not for citation purposes)
Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):P55
http://jcmr-online.com/content/12/S1/P55
Table 1:
RFA RIPV Diameter (mm) Flow (cm/s CBA RIPV Diameter (mm) Flow (cm/s)
Before PVAI
Acute after PVAI
24 hours after PVAI
11.7 ± 1.83 34.28 ± 13.97
9.1 ± 2.42* 42.46 ± 13.99°
11.2 ± 2.66^ 4
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