Author + information
- Borislav Dinov,
- Sabrina Oebel,
- Sebastian Hilbert,
- Susanne Loebe,
- Arash Arya,
- Andreas Bollmann,
- Gerhard Hindricks,
- Cosima Jahnke and
- Ingo Paetsch
Background: Cardiac magnetic resonance (CMR) may help to identify the underlying arrhythmogenic substrate in patients undergoing radiofrequency (RF) ablation for ventricular arrhythmias (VA). We aimed to assess the extent of the structural damage induced by the RF ablation and its association with the acute procedural outcomes.
Methods: 20 patients (18 male, mean age 60.5 ± 10.5 years) received RF ablation for VA using a 3.5 mm Thermocool catheter. Abolishment of ventricular premature beats or non- inducibility of VT at the end of the procedure were defined as acute success. CMR scans (1.5 T) using LGE were performed pre- and post-RF ablation. The LGE volume in preablation CMR, as well as the volume and transmurality of the nonenhanced (NE) RF-induced lesions in postablation EGE-CMR were measured. The CMR characteristics were correlated with the procedural characteristics and the acute outcome.
Results: All patients displayed characteristic appearance of the RF lesions in post-ablation CMR: NE core and hyperenhanced (HE) brim. The volume of the NE lesions in the post-CMR showed positive correlation with the total RF time (r=0.692; P=0.001) and the mean impedance drop (r=0.565; P=0.009). In patients showing transmural NE (≥ 75%) in postablation CMR, the mean impedance drop was significantly greater as compared to patients with NE < 75%: 23.5 ± 11.9 vs. 13.9 ± 4.3; P=0.014. In patients with acute ablation failure, the NE volume was slightly larger than those with acute success: 6 ± 3.2 % vs. 4.9 ± 1.1 %; P=0.236. However, the NE lesions were deeper in patients with acute failure: 80 ± 27.4% vs. 57 ± 14.8%; P=0.024. There was no acute worsening of the LV systolic function after RFCA.
Conclusions: Postprocedural CMR revealed RF-related NE lesions that resemble the no-reflow lesions in acute infarction. The size and depth of the RF-induced injury correlated linearly with the impedance drop, however, were not associated with procedural success.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Atrial Fibrillation and VT: Specific Situations and Newer Outcome Measures
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1190-101
- 2017 American College of Cardiology Foundation