MRI Meets A-Fib and Does Well

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Chris P. Kaiser, Editor
Atrial fibrillation ablation and MRI essentially have remained in their respective separate corners. That may change soon as researchers are beginning to find promise in uniting the two techniques.

In our first top story, investigators took an established MRI technique and successfully applied it to post-atrial fibrillation ablation therapy. The delayed contrast-enhanced technique, visualized in 3D, showed the degree of ablation scarring and a threshold of 13 percent scarring predicted successful a-fib treatment.

The University of Utah researchers now routinely use MRI to monitor and follow a-fib patients—another example of how cardiac imaging is being utilized to help interventional and EP cardiologists perform their jobs better.

Our second top story ventures into a controversial area, namely, the so-called triple rule-out. The triple rule-out is a CTA scan that allows evaluation of the coronary arteries, pulmonary arteries and the aorta. The advantage of performing this one-stop-shop type of scan is somewhat overshadowed by the disadvantages, which include more radiation exposure than a routine coronary CTA and the need for a longer patient breathold.  

So, the question becomes, How effective is a routine coronary CTA for evaluating the three circulatory systems covered in a triple rule-out protocol? Let’s just say that if you want to rule out all potential pulmonary embolisms (PE), you’ll have to perform a dedicated PE or a triple rule-out scan.

I’d also like to highlight a featured story about a newly formed ultrasound contrast agent society. With all the trouble echo contrast agents have had over the past several years, the formation of this society could help galvanize support for the much-maligned technique.

And finally, the more imaging employed in cardiovascular care, the more critical it becomes for all practices to be able to manipulate, store, archive and access those images. To help you out with this pursuit, please feel free to access our archived webcast, “Cardiology PACS & CVIS: Implementing Digital Strategies.” You’ll find it well worth the effort.

If you have any comments on cardiac imaging, please send them to me.

Chris P. Kaiser, Editor