Research ExplorerPublicationsDetection of brain lesions after catheter ablation depends o...

Detection of brain lesions after catheter ablation depends on imaging criteria: insights from AXAFA-AFNET 5 trial

Standard

Detection of brain lesions after catheter ablation depends on imaging criteria: insights from AXAFA-AFNET 5 trial. / Haeusler, Karl Georg; Eichner, Felizitas A; Heuschmann, Peter U; Fiebach, Jochen B; Engelhorn, Tobias; Callans, David; De Potter, Tom; Debruyne, Philippe; Scherr, Daniel; Hindricks, Gerhard; Al-Khalidi, Hussein R; Mont, Lluis; Kim, Won Yong; Piccini, Jonathan P; Schotten, Ulrich; Themistoclakis, Sakis; Di Biase, Luigi; Kirchhof, Paulus.

In: EUROPACE, Vol. 25, No. 12, euad323, 06.12.2023.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Haeusler, KG, Eichner, FA, Heuschmann, PU, Fiebach, JB, Engelhorn, T, Callans, D, De Potter, T, Debruyne, P, Scherr, D, Hindricks, G, Al-Khalidi, HR, Mont, L, Kim, WY, Piccini, JP, Schotten, U, Themistoclakis, S, Di Biase, L & Kirchhof, P 2023, 'Detection of brain lesions after catheter ablation depends on imaging criteria: insights from AXAFA-AFNET 5 trial', EUROPACE, vol. 25, no. 12, euad323. https://doi.org/10.1093/europace/euad323

APA

Haeusler, K. G., Eichner, F. A., Heuschmann, P. U., Fiebach, J. B., Engelhorn, T., Callans, D., De Potter, T., Debruyne, P., Scherr, D., Hindricks, G., Al-Khalidi, H. R., Mont, L., Kim, W. Y., Piccini, J. P., Schotten, U., Themistoclakis, S., Di Biase, L., & Kirchhof, P. (2023). Detection of brain lesions after catheter ablation depends on imaging criteria: insights from AXAFA-AFNET 5 trial. EUROPACE, 25(12), [euad323]. https://doi.org/10.1093/europace/euad323

Vancouver

Haeusler KG, Eichner FA, Heuschmann PU, Fiebach JB, Engelhorn T, Callans D et al. Detection of brain lesions after catheter ablation depends on imaging criteria: insights from AXAFA-AFNET 5 trial. EUROPACE. 2023 Dec 6;25(12). euad323. https://doi.org/10.1093/europace/euad323

Bibtex

@article{ad7fc0c77a0a42a8a7e54a60597da41a,
title = "Detection of brain lesions after catheter ablation depends on imaging criteria: insights from AXAFA-AFNET 5 trial",
abstract = "AIMS: Left atrial catheter ablation is well established in patients with symptomatic atrial fibrillation (AF) but associated with risk of embolism to the brain. The present analysis aims to assess the impact of diffusion-weighted imaging (DWI) slice thickness on the rate of magnetic resonance imaging (MRI)-detected ischaemic brain lesions after ablation.METHODS AND RESULTS: AXAFA-AFNET 5 trial (NCT02227550) participants underwent MRI using high-resolution (hr) DWI (slice thickness: 2.5-3 mm) and standard DWI (slice thickness: 5-6 mm) within 3-48 h after ablation. In 321 patients with analysable brain MRI (mean age 64 years, 33% female, median CHA2DS2-VASc 2), hrDWI detected at least one acute brain lesion in 84 (26.2%) patients and standard DWI in 60 (18.7%; P < 0.01) patients. High-resolution diffusion-weighted imaging detected more lesions compared to standard DWI (165 vs. 104; P < 0.01). The degree of agreement for lesion confirmation using hrDWI vs. standard DWI was substantial (κ = 0769). Comparing the proportion of DWI-detected lesions, lesion distribution, and total lesion volume per patient, there was no difference in the cohort of participants undergoing MRI at 1.5 T (n = 52) vs. 3 T (n = 269).CONCLUSION: The pre-specified AXAFA-AFNET 5 sub-analysis revealed significantly increased rates of MRI-detected acute brain lesions using hrDWI instead of standard DWI in AF patients undergoing ablation. In comparison to DWI slice thickness, MRI field strength had a no significant impact in the trial. Comparing the varying rates of ablation-related MRI-detected brain lesions across previous studies has to consider these technical parameters. Future studies should use hrDWI, as feasibility was demonstrated in the multicentre AXAFA-AFNET 5 trial.",
keywords = "Humans, Female, Middle Aged, Male, Magnetic Resonance Imaging/methods, Diffusion Magnetic Resonance Imaging/methods, Brain/diagnostic imaging, Atrial Fibrillation/diagnostic imaging, Catheter Ablation/adverse effects",
author = "Haeusler, {Karl Georg} and Eichner, {Felizitas A} and Heuschmann, {Peter U} and Fiebach, {Jochen B} and Tobias Engelhorn and David Callans and {De Potter}, Tom and Philippe Debruyne and Daniel Scherr and Gerhard Hindricks and Al-Khalidi, {Hussein R} and Lluis Mont and Kim, {Won Yong} and Piccini, {Jonathan P} and Ulrich Schotten and Sakis Themistoclakis and {Di Biase}, Luigi and Paulus Kirchhof",
note = "{\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.",
year = "2023",
month = dec,
day = "6",
doi = "10.1093/europace/euad323",
language = "English",
volume = "25",
journal = "EUROPACE",
issn = "1099-5129",
publisher = "Oxford University Press",
number = "12",

}

RIS

TY - JOUR

T1 - Detection of brain lesions after catheter ablation depends on imaging criteria: insights from AXAFA-AFNET 5 trial

AU - Haeusler, Karl Georg

AU - Eichner, Felizitas A

AU - Heuschmann, Peter U

AU - Fiebach, Jochen B

AU - Engelhorn, Tobias

AU - Callans, David

AU - De Potter, Tom

AU - Debruyne, Philippe

AU - Scherr, Daniel

AU - Hindricks, Gerhard

AU - Al-Khalidi, Hussein R

AU - Mont, Lluis

AU - Kim, Won Yong

AU - Piccini, Jonathan P

AU - Schotten, Ulrich

AU - Themistoclakis, Sakis

AU - Di Biase, Luigi

AU - Kirchhof, Paulus

N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.

PY - 2023/12/6

Y1 - 2023/12/6

N2 - AIMS: Left atrial catheter ablation is well established in patients with symptomatic atrial fibrillation (AF) but associated with risk of embolism to the brain. The present analysis aims to assess the impact of diffusion-weighted imaging (DWI) slice thickness on the rate of magnetic resonance imaging (MRI)-detected ischaemic brain lesions after ablation.METHODS AND RESULTS: AXAFA-AFNET 5 trial (NCT02227550) participants underwent MRI using high-resolution (hr) DWI (slice thickness: 2.5-3 mm) and standard DWI (slice thickness: 5-6 mm) within 3-48 h after ablation. In 321 patients with analysable brain MRI (mean age 64 years, 33% female, median CHA2DS2-VASc 2), hrDWI detected at least one acute brain lesion in 84 (26.2%) patients and standard DWI in 60 (18.7%; P < 0.01) patients. High-resolution diffusion-weighted imaging detected more lesions compared to standard DWI (165 vs. 104; P < 0.01). The degree of agreement for lesion confirmation using hrDWI vs. standard DWI was substantial (κ = 0769). Comparing the proportion of DWI-detected lesions, lesion distribution, and total lesion volume per patient, there was no difference in the cohort of participants undergoing MRI at 1.5 T (n = 52) vs. 3 T (n = 269).CONCLUSION: The pre-specified AXAFA-AFNET 5 sub-analysis revealed significantly increased rates of MRI-detected acute brain lesions using hrDWI instead of standard DWI in AF patients undergoing ablation. In comparison to DWI slice thickness, MRI field strength had a no significant impact in the trial. Comparing the varying rates of ablation-related MRI-detected brain lesions across previous studies has to consider these technical parameters. Future studies should use hrDWI, as feasibility was demonstrated in the multicentre AXAFA-AFNET 5 trial.

AB - AIMS: Left atrial catheter ablation is well established in patients with symptomatic atrial fibrillation (AF) but associated with risk of embolism to the brain. The present analysis aims to assess the impact of diffusion-weighted imaging (DWI) slice thickness on the rate of magnetic resonance imaging (MRI)-detected ischaemic brain lesions after ablation.METHODS AND RESULTS: AXAFA-AFNET 5 trial (NCT02227550) participants underwent MRI using high-resolution (hr) DWI (slice thickness: 2.5-3 mm) and standard DWI (slice thickness: 5-6 mm) within 3-48 h after ablation. In 321 patients with analysable brain MRI (mean age 64 years, 33% female, median CHA2DS2-VASc 2), hrDWI detected at least one acute brain lesion in 84 (26.2%) patients and standard DWI in 60 (18.7%; P < 0.01) patients. High-resolution diffusion-weighted imaging detected more lesions compared to standard DWI (165 vs. 104; P < 0.01). The degree of agreement for lesion confirmation using hrDWI vs. standard DWI was substantial (κ = 0769). Comparing the proportion of DWI-detected lesions, lesion distribution, and total lesion volume per patient, there was no difference in the cohort of participants undergoing MRI at 1.5 T (n = 52) vs. 3 T (n = 269).CONCLUSION: The pre-specified AXAFA-AFNET 5 sub-analysis revealed significantly increased rates of MRI-detected acute brain lesions using hrDWI instead of standard DWI in AF patients undergoing ablation. In comparison to DWI slice thickness, MRI field strength had a no significant impact in the trial. Comparing the varying rates of ablation-related MRI-detected brain lesions across previous studies has to consider these technical parameters. Future studies should use hrDWI, as feasibility was demonstrated in the multicentre AXAFA-AFNET 5 trial.

KW - Humans

KW - Female

KW - Middle Aged

KW - Male

KW - Magnetic Resonance Imaging/methods

KW - Diffusion Magnetic Resonance Imaging/methods

KW - Brain/diagnostic imaging

KW - Atrial Fibrillation/diagnostic imaging

KW - Catheter Ablation/adverse effects

U2 - 10.1093/europace/euad323

DO - 10.1093/europace/euad323

M3 - SCORING: Journal article

C2 - 37897713

VL - 25

JO - EUROPACE

JF - EUROPACE

SN - 1099-5129

IS - 12

M1 - euad323

ER -