Usefulness of non-contrast-enhanced MRI with two-dimensional balanced steady-state free precession for the acquisition of the pulmonary venous and left atrial anatomy pre catheter ablation of atrial fibrillation: Comparison with contrast enhanced CT in clinical cases

J Magn Reson Imaging. 2016 Feb;43(2):495-503. doi: 10.1002/jmri.24990. Epub 2015 Jul 7.

Abstract

Background: To investigate the feasibility of substituting non-contrast-enhanced MR (non-CE-MR) imaging with a two-dimensional (2D) balanced steady-state free precession (b-SSFP) sequence for contrast-enhanced computed tomography (CE-CT) for atrial fibrillation (AF) ablation.

Methods: Fifty-four patients that underwent AF ablation under the guidance of a 3D electro-anatomical mapping system with CE-CT (n = 27) or non-CE-MR images (n = 27) were studied. Procedural results were compared between the two groups. Furthermore, in 22 patients who underwent both CE-CT and non-CE-MRI, two cardiologists independently scored the multiplanar reformatted images on a scale of 1 to 4 (from 1, poor, to 4, excellent).

Results: The image score was nearly 0.5 point higher with the CE-CT method. However, the procedural results such as the surface registration error (1.0 [0.8-1.6] mm versus 1.0 [0.8-1.35] mm, P = 0.88) and procedure time (185 [159-199] min versus 185 [142-221] min, P = 0.86) did not significantly differ between the CE-CT and non-CE-MR groups.

Conclusion: The non-CE-MR method with a 2D-b-SSFP sequence can give us adequate information on AF ablation without any radiation exposure or contrast medium usage

Keywords: atrial fibrillation (AF); electro-anatomical mapping system (EAM); left atrium (LA); magnetic resonance imaging (MRI); pulmonary vein (PV); steady-state free precession (SSFP).

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Atrial Fibrillation / surgery
  • Catheter Ablation
  • Contrast Media*
  • Feasibility Studies
  • Female
  • Heart Atria / anatomy & histology
  • Heart Atria / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Preoperative Care / methods*
  • Pulmonary Veins / anatomy & histology*
  • Pulmonary Veins / diagnostic imaging
  • Radiographic Image Enhancement*
  • Reproducibility of Results
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media