Acute Lesion Imaging in Predicting Chronic Tissue Injury in the Ventricles

Abstract

Background: Chronic lesion formation after cardiac tissue ablation is an important indicator for procedural outcome. Moreover, there is a lack of knowledge regarding the features that predict chronic lesion formation. Objective: The aim of this study is to determine whether acute lesion visualization using late gadolinium enhanced magnetic resonance imaging (LGE-MRI) can reliably predict chronic lesion size. Methods: Focal lesions were created in left and right ventricles of canine models using either radiofrequency (RF) ablation or cryofocal ablation. Multiple ablation parameters were used. The first LGE-MRI was acquired within 1–5 h post-ablation and the second LGE-MRI was obtained 47–82 days later. Corview software was used to perform lesion segmentations and size calculations. Results: Fifty-Five lesions were created in different locations in the ventricles. Chronic volume size decreased by a mean of 62.5 % (95% CI 58.83–67.97, p < 0.0005). Similar regression of lesion volume was observed regardless of ablation location (p = 0.32), ablation technique (p = 0.94), duration (p = 0.37), power (p = 0.55) and whether lesions were connected or not (p = 0.35). There was no significant difference in lesion volume reduction assessed at 47–54 days and 72–82 days after ablation (p = 0.31). Chronic lesion volume was equal to 0.32 of the acute lesion volumes (R2 = 0.75). Conclusion: Chronic tissue injury related to catheter ablation can be reliably modeled as a linear function of the acute lesion volume as assessed by LGE-MRI, regardless of the ablation parameters.