Evidence map›Paper›PMID 29530833›Full record

ArticleHeart rhythm2018

Visualization of acute edema in the left atrial myocardium after radiofrequency ablation: Application of a novel high-resolution 3-dimensional magnetic resonance imaging sequence.

Tarek Zghaib, Ashkan A Malayeri, Esra G Ipek, Mohammadali Habibi, Dong Huang, Muhammad A Balouch, David A Bluemke, Hugh Calkins, Saman Nazarian, Stefan L Zimmerman

Open access · greenAbstract readComparative StudyValidation Study
In one paragraph

Article in Heart rhythm, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 16 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Advances in Real-Time MRI-Guided Electrophysiology.Current cardiovascular imaging reports · 2019
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Tarek ZghaibDivision of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: tarek.z@jhmi.edu.
Ashkan A MalayeriRadiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland.
Esra G IpekDivision of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Mohammadali HabibiDivision of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Dong HuangDivision of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Muhammad A BalouchDivision of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
David A BluemkeRadiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland.
Hugh CalkinsDivision of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Saman NazarianDivision of Cardiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Stefan L ZimmermanDepartment of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Johns Hopkins University · USNational Institutes of Health Clinical Center · USUniversity of Pennsylvania · US

Funding

ANCILLARY STUDY OF SUBSTRATE AND INTERVENTION MECHANISMS FOR MALIGNANT ARRHYTHMIAR01HL116280 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI NAZARIAN, SAMAN · 2013 to 2016
$1.2M
Applications of Magnetic Resonance for Management of Ventricular TachycardiaK23HL089333 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI NAZARIAN, SAMAN · 2010 to 2014
$686k
NHLBI NIH HHS K23 HL089333NHLBI NIH HHS R01 HL116280
6 · The paper itself

Abstract

backgroundAblation-induced left atrial (LA) edema may result in procedural failure due to reversible pulmonary vein isolation. Conventional T2-weighted magnetic resonance edema imaging is limited by low spatial resolution.

objectiveThe purpose of this pilot study was to optimize and validate a 3-dimensional (3D) sampling perfection with application-optimized contrasts using different flip-angle evolution (SPACE) sequence for quantification of T2 signal in the LA, and to apply it in recently ablated patients, comparing myocardial edema on T2-SPACE to tissue damage on late gadolinium enhancement (LGE) imaging.

methodsPhantom studies were performed to identify 3D-SPACE parameters for optimal contrast between normal and edematous myocardium. Fourteen AF patients were imaged with both 3D-SPACE and dark-blood turbo-spin echo (DB-TSE) to compare image quality and signal intensity between the 2 techniques. Eight patients underwent pre- and postablation 3D-SPACE and 3D-LGE imaging. Ablation points were co-registered with corresponding myocardial sectors, and ablation-induced changes in T2 and LGE signal intensities were measured.

resultsSignal-to-noise ratio and contrast-to-noise ratio were higher on SPACE vs DB-TSE (65.5 ± 33.9 vs 35.7 ± 17.9; P = .01; and 59.4 ± 33.0 vs 32.9 ± 17.7; P = .04, respectively). T2-signal correlated well on 3D-SPACE and DB-TSE, such that each unit increase in TSE intensity correlated with a 0.69-unit increase in SPACE intensity (95% confidence interval 0.56-0.82; P <.001). T2 and LGE signal intensities were acutely increased at ablation sites. The extent of postablation edema was higher compared to LGE, although the spatial distribution of hyperenhancement around pulmonary veins seemed similar in both modalities.

conclusionT2-SPACE can be used to map the extent of acute postablation edema in the thin LA myocardium, with improved resolution and lower artifact compared to traditional DB-TSE.

Indexed as

Acute DiseaseAdultAgedAged, 80 and overAtrial FibrillationCatheter AblationEdemaFemaleHeart AtriaHeart Conduction SystemHumansImaging, Three-DimensionalMagnetic Resonance Imaging, CineMaleMiddle AgedMyocardiumAtrial fibrillationLate gadolinium enhancementLeft atrial edemaLeft atrial fibrosisLeft atrial imagingRadiofrequency ablationT2-weighted imaging

Identifiers

PMID29530833
PMCPMC6067985
OpenAlexW2794254098

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.