Visualization of the radiofrequency lesion after pulmonary vein isolation using delayed enhancement magnetic resonance imaging fused with magnetic resonance angiography

AbstractBackgroundThe radiofrequency (RF) lesions for atrial fibrillation (AF) ablation can be visualized by delayed enhancement magnetic resonance imaging (DE-MRI). However, the quality of anatomical information provided by DE-MRI is not adequate due to its spatial resolution. In contrast, magnetic resonance angiography (MRA) provides similar information regarding the left atrium (LA) and pulmonary veins (PVs) as computed tomography angiography. We hypothesized that DE-MRI fused with MRA will compensate for the inadequate image quality provided by DE-MRI.MethodsDE-MRI and MRA were performed in 18 patients who underwent AF ablation (age, 60±9 years; LA diameter, 42±6mm). Two observers independently assessed the DE-MRI and DE-MRI fused with MRA for visualization of the RF lesion (score 0–2; where 0: not visualized and 2: excellent in all 14 segments of the circular RF lesion).ResultsDE-MRI fused with MRA was successfully performed in all patients. The image quality score was significantly higher in DE-MRI fused with MRA compared to DE-MRI alone (observer 1: 22 (18, 25) vs 28 (28, 28), p<0.001; observer 2: 24 (23, 25) vs 28 (28, 28), p<0.001).ConclusionsDE-MRI fused with MRA was superior to DE-MRI for visualization of the RF lesion owing to the precise information on LA and PV anatomy provided by DE-MRI

The Japanese space gravitational wave antenna; DECIGO

DECi-hertz Interferometer Gravitational wave Observatory (DECIGO) is the future Japanese space gravitational wave antenna. DECIGO is expected to open a new window of observation for gravitational wave astronomy especially between 0.1 Hz and 10 Hz, revealing various mysteries of the universe such as dark energy, formation mechanism of supermassive black holes, and inflation of the universe. The pre-conceptual design of DECIGO consists of three drag-free spacecraft, whose relative displacements are measured by a differential Fabry– Perot Michelson interferometer. We plan to launch two missions, DECIGO pathfinder and pre- DECIGO first and finally DECIGO in 2024

Demonstration for a two-axis interferometric tilt sensor in KAGRA

Recently, a folded Mach–Zehnder interferometer with homodyne in- and quadrature-phase detection was proposed as a high-precision, wide-dynamic range tilt sensor. By way of a practical application and to validate actual performance, two-axis tilt sensors were developed and installed for one mirror of the input mode cleaner cavity in KAGRA, the large-scale cryogenic gravitational-wave telescope in Kamioka, Gifu, Japan. Building on previous work, we have demonstrated that the two-axis tilt sensor has properly sensed the tilt angle changes of the mirror motion with high precision and without calibration. Compared with our initial angular sensor, an optical lever, which is calibrated by using the interferometer tilt sensor, we found that both sensors showed actual tilt motions of the mirror at low frequencies, and the two-axis interferometer sensor has a better sensitivity at higher frequencies

Demonstration for a two-axis interferometric tilt sensor in KAGRA

Recently, a folded Mach–Zehnder interferometer with homodyne in- and quadrature-phase detection was proposed as a high-precision, wide-dynamic range tilt sensor. By way of a practical application and to validate actual performance, two-axis tilt sensors were developed and installed for one mirror of the input mode cleaner cavity in KAGRA, the large-scale cryogenic gravitational-wave telescope in Kamioka, Gifu, Japan. Building on previous work, we have demonstrated that the two-axis tilt sensor has properly sensed the tilt angle changes of the mirror motion with high precision and without calibration. Compared with our initial angular sensor, an optical lever, which is calibrated by using the interferometer tilt sensor, we found that both sensors showed actual tilt motions of the mirror at low frequencies, and the two-axis interferometer sensor has a better sensitivity at higher frequencies

Visualizing radiofrequency lesions using delayed-enhancement magnetic resonance imaging in patients with atrial fibrillation: A modification of the method used by the University of Utah group

Background: Atrial tissue fibrosis has previously been identified using delayed-enhancement MRI (DE-MRI) in patients with atrial fibrillation (AF). Although the clinical importance of DE-MRI is well recognized, the visualization of atrial fibrosis and radiofrequency (RF) lesions has still not been achieved in Japan, primarily because of the differences in contrast agents, volume-rendering tools, and technical experience. The objective of this study was to visualize RF lesions by using commercially available tools. Methods: DE-MRI was performed in 15 patients who had undergone AF ablation (age, 59±4 years, left atrium diameter, 40±2 mm). Specific parameters for MR scanning obtained from previous reports were modified. Results: Of the 15 images, the images of three patients were uninterpretable owing to low image quality. RF lesions could be visualized in 8 (67%) of the 12 patients. Conclusions: In the current study, we successfully demonstrated that RF lesions could be visualized in Japanese patients using DE-MRI, although only commercially available tools were used

Incidence of esophageal injury after pulmonary vein isolation in patients with a low body mass index and esophageal temperature monitoring at a 39 °C setting

Background: Esophageal injury following catheter ablation of atrial fibrillation (AF) is reported to occur in 35% of patients. Even with a low energy setting (20–25 W), lesions develop in 10% of patients. Body mass index (BMI) has been reported to be a predictor of esophageal injury, indicating that patients with a low BMI (<24.9 kg/m2) are at a higher risk. We hypothesized that catheter ablation with a lower energy setting of 20 W controlled by esophageal temperature monitoring (ETM) at 39 °C could prevent esophageal injury even in patients with a BMI <24.9 kg/m2. Methods: Twenty patients with AF were included (age, 63±8 years; BMI, 22.9±1.3 kg/m2, left atrium diameter, 44±11 mm). If the esophageal temperature probe registered a temperature of >39 °C, radiofrequency (RF) application was stopped immediately. RF application could be performed in a “point by point” manner for a maximum of 20 s. Endoscopy was performed 1–5 days after ablation. Results: Esophageal mucosal injury was not observed in any patient in the study. Conclusions: Catheter ablation using ETM reduced the incidence of esophageal injuries, even in patients with a low BMI