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[磁共振成像在心房颤动导管消融中的相关性]

[Relevance of magnetic resonance imaging for catheter ablation of atrial fibrillation].

作者信息

Mahnkopf Christan, Mitlacher Marcel, Brachmann Johannes

机构信息

Klinikum Coburg, II. Medizinische Klinik, Klinik für Kardiologie, Angiologie, Pneumologie, Ketschendorferstraße 33, 96450, Coburg, Deutschland,

出版信息

Herzschrittmacherther Elektrophysiol. 2014 Dec;25(4):252-7. doi: 10.1007/s00399-014-0327-5. Epub 2014 Aug 27.

Abstract

Currently, atrial fibrillation is the most common form of arrhythmia encountered in clinical practice. Until recently the treatment approach to atrial fibrillation was limited by imprecise risk stratification models and suboptimal therapy options. At present cardiac magnetic resonance imaging (MRI) is an important noninvasive diagnostic modality which aids in the completion of complex electrophysiological and ablation interventions. Cardiac MRI and 3D imaging reconstruction are used clinically to assess the cardiac chambers as well as complex anatomical structures. Through the development of cardiac MRI it has become possible to detect areas of fibrosis in the left atrium which can be the cause of atrial fibrillation. The most recent clinical data suggest that there is a strong correlation between the amount of left atrial fibrosis and recurrent atrial fibrillation following ablation procedures and will in the future allow more individualized treatment strategies for patients with atrial fibrillation. In addition, cardiac MRI allows the direct visualization of catheter-induced lesions after ablation procedures which helps in assessing therapy success and can also assist in the early detection of procedure-related complications. Furthermore, with the implementation of cardiac MRI it appears possible to assess the stroke risk in patients with atrial fibrillation. Promising future developments will allow individualized therapy for patients with atrial fibrillation in addition to improving safety and procedure results after ablation.

摘要

目前,心房颤动是临床实践中最常见的心律失常形式。直到最近,心房颤动的治疗方法仍受限于不精确的风险分层模型和欠佳的治疗选择。目前,心脏磁共振成像(MRI)是一种重要的非侵入性诊断手段,有助于完成复杂的电生理和消融干预。心脏MRI和三维成像重建在临床上用于评估心脏腔室以及复杂的解剖结构。随着心脏MRI的发展,已能够检测出左心房中可能导致心房颤动的纤维化区域。最新临床数据表明,左心房纤维化程度与消融术后复发性心房颤动之间存在密切关联,未来这将使心房颤动患者能够采用更具个性化的治疗策略。此外,心脏MRI能够直接观察消融术后导管所致的损伤,这有助于评估治疗效果,还能辅助早期发现与手术相关的并发症。此外,随着心脏MRI的应用,似乎有可能评估心房颤动患者的中风风险。未来令人期待的发展将使心房颤动患者能够接受个性化治疗,同时提高消融术后的安全性和手术效果。

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