MRI-validated study of the superiority of a contact feedback catheter in AF ablation
Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, occurring in 1–2% of the general population. Over 6 million Europeans suffer from this arrhythmia, and its prevalence is estimated to at least double in the next 50 years as the population ages. Radiofrequency (RF) pulmonary vein isolation (PVI) represents an established therapy for treating atrial fibrillation (AF). The quality of catheter tip-to-tissue contact plays a critical role in ablation safety and efficacy. Catheters providing feedback on this tip-to-tissue contact have recently become available. Effectiveness of RF ablation by these catheters has recently been demonstrated in humans. MRI has shown to be of great value in assessing lesion size and transmurality in-vivo. To demonstrate the superiority of catheters with contact feedback to conventional catheters for the effectiveness of AF ablation, post procedural MRI with delayed enhancement (DE-MRI) can be of value to demonstrate lesion size, transmurality of the lesion and completeness of PVI and relate this to clinical outcome.
Objective: Up to now the demonstration of lesion size, transmurality of the lesion and completeness of PVI using MRI has only shown success in a study group in Canada, others have tried but did not succeed. In this pre study we already performed a post procedural MRI in 10 patients, these MRI’s need a large extend of post-processing to eventually succeed in demonstrating lesion size, transmurality and completeness. How this post processing is best performed is the objective of this project. After successful post-processing of the 10 pre-study MRI’s an advice towards the MRI protocol and post processing of the final study (100+ patients) needs to be established.
Location: The research project is a project at the UT and is supervised by the NIM (Neuroimaging - Magnetic Detection) group and. It initiated by and in collaboration with the cardiology department of the Thoraxcentre Twente Medisch Spectrum Twente.