Use of oral gadobenate dimeglumine to visualise the oesophagus during magnetic resonance angiography in patients with atrial fibrillation prior to catheter ablation

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• 作者：Riccardo Faletti (13)
  Alessandro Rapellino (13)
  Francesca Barisone (13)
  Matteo Anselmino (14)
  Federico Ferraris (14)
  Paolo Fonio (13)
  Fiorenzo Gaita (14)
  Giovanni Gandini (13)
  
  13. Istituto di Radiologia dell鈥橴niversit脿 degli Studi di Torino ; A.O. Citt脿 della Salute e della Scienza ; Via Genova 3 ; 10126 ; Torino ; Italy
  14. Istituto di Cardiologia dell鈥橴niversit脿 degli Studi di Torino ; A.O. Citt脿 della Salute e della Scienza ; Corso Dogliotti 14 ; 10126 ; Torino ; Italy
  
• 关键词：Atrial fibrillation ; Percutaneous endocardial radiofrequency ablation ; Magnetic resonance angiography ; Atrio ; esophageal fistula ; Gadobenate dimeglumine oral administration
• 刊名：Journal of Cardiovascular Magnetic Resonance
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：16
• 期：1
• 全文大小：858 KB
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  MultiHance庐 (gadobenate dimeglumine injection) United States Package Insert. Bracco Diagnostics Inc, Princeton, New Jersey
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  AIFA. Prontuario Farmaceutico Nazionale Italiano, Roma
  
• 刊物主题：Imaging / Radiology; Angiology; Cardiology;
• 出版者：BioMed Central
• ISSN：1532-429X

文摘

Background Atrio-oesophageal fistula was first reported as a fatal complication of surgical endocardial and percutaneous endocardial radiofrequency ablation for atrial fibrillation, with an incidence after catheter ablation between 0.03% and 0.5%. Magnetic resonance angiography (MRA) was usually performed to obtain pre-procedural 3D images, used to merging into an electro-anatomical map, guiding step-by-step ablation strategy of AF. Our aim was to find an easy, safe and cost-effective way to enhance the oesophagus during MRA. Methods In 105 consecutive patients, a right-left phase encoding, free breathing, 3D T1 MRA sequence was performed in the axial plane, >24 hours before catheter ablation, using an intravenous injection of gadobenate dimeglumine contrast medium. The oesophagus was enhanced using an oral gel solution of 0.7 mL gadobenate dimeglumine contrast medium mixed with approximately 40 mg thickened water gel, which was swallowed by the patients on the scanning table, immediately before the MRA sequence acquisition. Results The visualisation of the oesophagus was obtained in 104/105 patients and images were successfully merged, as left atrium and pulmonary veins, into an electro-anatomical map, during percutaneous endocardial radiofrequency ablation. All patients tolerated the study protocol and no immediate or late complication was observed with the oral contrast agent administration. The free-breathing MRA sequence used in our protocol took 7 seconds longer than MRA breath-hold conventional sequence. Conclusion Oesophagus visualization with oral gadobenate dimeglumine is feasible for integration of oesophagus anatomy images into the electro-anatomical map during AF ablation, without undesirable side effects and without significantly increasing cost or examination time.