Characterization of acute and subacute radiofrequency ablation lesions with nonenhanced magnetic resonance imaging

Timm Dickfeld, Ritsushi Kato, Menekem Zviman, Saman Nazarian, Jun Dong, Hiroshi Ashikaga, Albert C. Lardo, Ronald D Berger, Hugh Calkins, Henry R Halperin

Research output: Contribution to journalArticle

Abstract

Background: Magnetic resonance imaging (MRI) has the potential to visualize radiofrequency (RF) ablations, which have become the preferred strategy for treatment of many arrhythmias. However, MRI patterns after RF ablation have not been well investigated. Objective: The purpose of this study was to define the characteristic appearance and the effect of time and energy on noncontrast-enhanced MRI of RF ablation. Methods: Using a power-controlled, cooled-tip ablation system, RF ablation lesions (5-50 W for 45 seconds) were created on the right ventricular epicardium in 10 mongrel dogs. T1- and T2-weighted MR images were obtained during 12-hour follow-up and compared with gross anatomy and histopathology. Results: Lesions were successfully visualized with T2- and T1-weighted images 30 minutes to 12 hours after RF ablation. T2 images were more consistent and displayed a characteristic elliptical, high-signal core (contrast-to-noise-ratio [CNR] = 18.9 ± 8.4) with a surrounding 0.5-mm low-intensity rim that on histopathology corresponded to the central tissue necrosis and the transition zone, respectively. T1 images showed a less remarked increase in signal intensity (CNR = 9.6 ± 7.4) without a surrounding rim. Lesion size and appearance were well defined and unchanged during the 12-hour follow-up (analysis of variance). CNR was independent of applied RF energy and allowed accurate assessment of RF ablation at all time points (r = 0.87 and r = 0.83 for T2 and T1 images, respectively). Transmural lesions, interlesional gaps, and intralesional pathology could be reliably predicted in >90%. Conclusion: Noncontrast-enhanced MRI allows accurate assessment of RF ablation and its intralesional pathology during 12-hour follow-up. This finding confirms a possible role of MRI in guiding and evaluating RF application during electrophysiologic ablation procedures.

Original languageEnglish (US)
Pages (from-to)208-214
Number of pages7
JournalHeart Rhythm
Volume4
Issue number2
DOIs
StatePublished - Feb 2007

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Magnetic Resonance Imaging
Noise
Pathology
Pericardium
Cardiac Arrhythmias
Anatomy
Analysis of Variance
Necrosis
Dogs

Keywords

  • Ablation lesion
  • Arrhythmia
  • Catheter ablation
  • Electrophysiology
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Characterization of acute and subacute radiofrequency ablation lesions with nonenhanced magnetic resonance imaging. / Dickfeld, Timm; Kato, Ritsushi; Zviman, Menekem; Nazarian, Saman; Dong, Jun; Ashikaga, Hiroshi; Lardo, Albert C.; Berger, Ronald D; Calkins, Hugh; Halperin, Henry R.

In: Heart Rhythm, Vol. 4, No. 2, 02.2007, p. 208-214.

Research output: Contribution to journalArticle

Dickfeld, Timm ; Kato, Ritsushi ; Zviman, Menekem ; Nazarian, Saman ; Dong, Jun ; Ashikaga, Hiroshi ; Lardo, Albert C. ; Berger, Ronald D ; Calkins, Hugh ; Halperin, Henry R. / Characterization of acute and subacute radiofrequency ablation lesions with nonenhanced magnetic resonance imaging. In: Heart Rhythm. 2007 ; Vol. 4, No. 2. pp. 208-214.
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AU - Kato, Ritsushi

AU - Zviman, Menekem

AU - Nazarian, Saman

AU - Dong, Jun

AU - Ashikaga, Hiroshi

AU - Lardo, Albert C.

AU - Berger, Ronald D

AU - Calkins, Hugh

AU - Halperin, Henry R

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