Arrhythmias & electrophysiology
Detection of brain lesions after catheter ablation depends on imaging criteria: insights from AXAFA-AFNET 5 trial
Authors' 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.
Study context
- Population
- Patients with atrial fibrillation (AF) undergoing left atrial catheter ablation, magnetic resonance imaging (MRI) within 3–48 h after ablationanalysable brain MRI
- Participants
- 321 patients
- Comparison
- hrDWI vs Standard diffusion-weighted imaging (DWI)
- Primary endpoint
- Rate of MRI-detected acute ischaemic brain lesions after ablation
- Follow-up
- 3-48 h after ablation
Methodological detailspre-specified sub-analysis, multicentre
- Pre-specified sub-analysis
- Multicentre
Primary result
As reported in the abstract
≥1 acute brain lesion
P < 0.01
Further findings
Events
| Outcome | hrDWI | Standard DWI | P value |
|---|---|---|---|
| Total number of lesions | 165 | 104 | P < 0.01 |
Agreement for lesion confirmation, hrDWI vs standard DWI
- Substantial agreement (κ)
- 0769
Proportion of DWI-detected lesions, lesion distribution, total lesion volume per patient: 1.5 T (n = 52) vs 3 T (n = 269)
- No difference between 1.5 T and 3 T
Original publication
Detection of brain lesions after catheter ablation depends on imaging criteria: insights from AXAFA-AFNET 5 trial. Europace. Published 28 October 2023. doi:10.
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