Magnetic resonance imaging allows acute and long-term identification of myocardial injury in patients receiving pulmonar
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Magnetic resonance imaging allows acute and long-term identification of myocardial injury in patients receiving pulmonary vein isolation Anil-Martin Sinha*1, Nathan Burgon2, Christian Mahnkopf1, Guido Ritscher1, Thom Haslam2, Maximilian Kunzelmann1, Martin Schmidt1, Harald Marschang1, Nassir F Marrouche2 and Johannes Brachmann1 Address: 1Klinikum Coburg, Coburg, Germany and 2University of Utah, School of Medicine, Salt Lake City, UT, USA * 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):P118
doi:10.1186/1532-429X-12-S1-P118
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/P118 © 2010 Sinha et al; licensee BioMed Central Ltd.
Introduction Pulmonary vein antrum isolation (PVAI) is regarded as an effective therapy in patients with atrial fibrillation (AF). Extension and location of ablation lesions often remain unclear during the procedure.
15.7 ± 6.4% long-term after PVAI. Figure 1 shows an example of MIP of a DE scan in 2D (A-C) and 3D segmentation (D-F) in a anterior view pre (A, D), during (B, E), and long-term after PVAI (C, F). Myocardial injury is iden-
Purpose To report a new approach on visualization of myocardial injury using cardiac magnet resonance imaging (CMR) during PVAI procedures, and to compare the results with long-term data.
Methods Patients who underwent PVAI, received CMR before, at the terminal phase of PVAI, and 13 ± 3 weeks after PVAI. Delayed enhancement (DE) sequences were applied, and maximum intensity projections (MIP) obtained. Myocardial injury size was then measured on manually segmented 3D images by a computer algorithm using dynamic thresholding.
Results 20 patients (13 male, age 62 ± 9 years) received CMR (Siemens Espree 1.5 T, Germany) before, during and after the PVAI procedure. Using DE-MRI, the average lesion to healthy myocardium ratio was 15.3 ± 7.2% during, and
Figure 1
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Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):P118
http://jcmr-online.com/content/12/S1/P118
tifiable as white tissue around PV single ostia (full arrows) and common trunk (dashed arrows).
Conclusion CMR is feasible during and after ablation procedures, and allows identification of acute and long-term myocardial injury. Extension of scar tissues seemed to be stable during long-term follow-up. Therefore, this new CMR approach might support current ablation techniques, and thus might improve long-term success of PVAI.
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