Atrial Fibrillation

IHeart: Cardiac & Vascular Imaging: Pre- and post-operative MRI assessments can improve ablation procedure outcomes in patients suffering from atrial fibrillation.

As catheter ablation has become an increasingly popular and accepted treatment for atrial fibrillation, the role of MR imaging to support the procedure has expanded to include guiding patient selection, pre-surgical planning, and post-surgical confirmation of the integrity of the procedure. This role is recognized by reimbursement policies of major insurance companies.

See also:  Aetna Policy 0520. Cigna Policy 0154.

Role of MRI in Guiding Ablation Procedures

In newer ablation techniques, accurately visualizing the lesions with respect to their extent and anatomic location is increasingly important. Techniques which rely on fluoroscopy and three-dimensional mapping to guide the catheter “are limited in their ability to confirm the presence, exact location, and extent of ablation lesions, parameters that serve as indicators of the procedural success.” MRI can provide this anatomical assessment in a systematic, repeatable manner. ^{(Source: Dickfeld, et al)}

Use of preacquired MR images with market-leading 3-D electroanatomical navigation systems provides superior support to visualize, diagnose, and guide treatment for arrhythmia. These navigation systems merge 2-D and 3-D MR images with electroanatomical data to facilitate catheter navigation, pre-procedure planning, and therapy delivery.

See also: CARTO XP EP Navigation System by Biosense Webster and EnSite™ System by St. Jude Medical.

MRI and Ablation Preparation

MRI is an effective imaging tool for planning and roadmapping surgical interventions, including patient selection.

• Detailed anatomical visualization. MRI has been found to be “superior to TEE in displaying pulmonary veins” and navigating the complex structures in the area around the confluence of these veins. MRI is “particularly effective in the diagnosis of pulmonary venous abnormalities.” ^{(Source:Yang, et al). Read Full Article}