Usefulness of non–contrast‐enhanced MRI with two‐dimensional balanced steady‐state free precession for the acquisition of the pulmonary venous and left atrial anatomy pre catheter ablation of atrial fibrillation: Comparison with contrast enhanced CT in clinical cases

Background To investigate the feasibility of substituting non–contrast-enhanced MR (non–CE-MR) imaging with a two-dimensional (2D) balanced steady-state free precession (b-SSFP) sequence for contrast-enhanced computed tomography (CE-CT) for atrial fibrillation (AF) ablation. Methods Fifty-four patients that underwent AF ablation under the guidance of a 3D electro-anatomical mapping system with CE-CT (n = 27) or non–CE-MR images (n = 27) were studied. Procedural results were compared between the two groups. Furthermore, in 22 patients who underwent both CE-CT and non–CE-MRI, two cardiologists independently scored the multiplanar reformatted images on a scale of 1 to 4 (from 1, poor, to 4, excellent). Results The image score was nearly 0.5 point higher with the CE-CT method. However, the procedural results such as the surface registration error (1.0 [0.8–1.6] mm versus 1.0 [0.8–1.35] mm, P = 0.88) and procedure time (185 [159–199] min versus 185 [142–221] min, P = 0.86) did not significantly differ between the CE-CT and non–CE-MR groups. Conclusion The non–CE-MR method with a 2D-b-SSFP sequence can give us adequate information on AF ablation without any radiation exposure or contrast medium usage. J. Magn. Reson. Imaging 2015.