Cardiac Magnetic Resonance for Lesion Assessment in the Electrophysiology Laboratory
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See Article by Ghafoori et al
Cardiac magnetic resonance imaging (CMR) is of growing importance in cardiac electrophysiology. This imaging modality is clinically used for the diagnosis of arrhythmogenic substrates, prognosis of sudden cardiac death, preprocedural planning, and procedural image integration.1–3 Because of the increasing use of CMR in the electrophysiology environment, interest in the use of real-time CMR for electrophysiology procedural guidance has amplified in recent years. This is an attractive option for many reasons. Currently, there is considerable radiation exposure to both patients and providers during electrophysiology procedures, and CMR offers a welcome radiation-free alternative to fluoroscopy.4 The other fundamental advantage of CMR over other imaging techniques is enhanced visualization of soft tissue structures with excellent spatial and temporal resolution. The enhanced soft tissue resolution with CMR promises not only to enhance the identification of arrhythmogenic substrates during the procedure but also to augment lesion assessment to distinguish acute edema in the setting of an ablation from the chronic lesion that ultimately results.5 This distinction may be critical because a significant proportion of long-term arrhythmia recurrences after acutely successful pulmonary vein isolation or other substrate or trigger ablations are likely attributable to resolution of acute edema that does not persist …