Ablation lesions in Koch's triangle assessed by three-dimensional myocardial contrast echocardiography

• Main Authors: Cate Folkert, Thornton Andrew, Scholten Marcoen, Kimman Geert-Jan, Szili-Torok Tamas, Roelandt Jos, Jordaens Luc
• Format: Article
• Language: English
• Published: BMC 2004-12-01
• Series: Cardiovascular Ultrasound
• Online Access: http://www.cardiovascularultrasound.com/content/2/1/27

<p>Abstract</p> <p>Background</p> <p>Myocardial contrast echocardiography (MCE) allows visualization of radiofrequency (RF) ablation lesions in the left ventricle in an animal model. Aim: To test whether MCE allows visualization of RF and cryo ablation lesions in the human right atrium using three-dimensional echocardiography.</p> <p>Methods</p> <p>18 patients underwent catheter ablation of a supraventricular tachycardia and were included in this prospective single-blind study. Twelve patients were ablated inside Koch's triangle and 6, who served as controls, outside this area. Three-dimensional echocardiography of Koch's triangle was performed before and after the ablation procedure in all patients, using respiration and ECG gated pullback of a 9 MHz ICE transducer, with and without continuous intravenous echocontrast infusion (SonoVue, Bracco). Two independent observers analyzed the data off-line.</p> <p>Results</p> <p>MCE identified ablation lesions as a low contrast area within the normal atrial myocardial tissue. Craters on the endocardial surface were seen in 10 (83%) patients after ablation. Lesions were identified in 11 out of 12 patients (92%). None of the control patients were recognized as having been ablated. The confidence score of the independent echo reviewer tended to be higher when the number of applications increased.</p> <p>Conclusions</p> <p>1. MCE allows direct visualization of ablation lesions in the human atrial myocardium. 2. Both RF and cryo energy lesions can be identified using MCE.</p>