Magnetic Resonance Imaging and Atrial Fibrillation Ablation Studies SAF 122 14.00-17.00

Magnetic resonance is a safe and non-invasive imaging technique. By exploiting inherent differences in the relaxation properties of tissues, by using contrast agents or by exploiting flow, a vast range of structural and functional data can be acquired which can aid cardiovascular diagnosis or monitor treatment. This workshop will focus on how MR imaging can be used to assist electrophysiology (EP) studies of atrial fibrillation.

Atrial fibrillation (AF) is the most common form of heart rhythm disturbance and is associated with increased rates of stroke, heart failure and death. Radiofrequency ablation is a common treatment which aims to electrically isolate the pulmonary veins which are a frequent source of ectopic beats. However, the 1-year success rates for single-catheter ablation procedures of persistent and paroxysmal AF are sub-optimal (51% and 69% respectively) and repeat procedures are often necessary.

MR imaging can assist AF ablation studies in two ways: firstly, it can be used to establish the complex and highly variable pulmonary vein anatomy prior to the ablation study and secondly, a technique called 3D late gadolinium enhancement (LGE) imaging can potentially be used to assess fibrosis and atrial scarring pre- and post-ablation. Recent studies have shown that post-ablation atrial scarring is related to mapping voltages and the spatial distribution and extent of this scarring has been shown to be related to the likelihood of AF recurrence. However, 3D LGE imaging – particularly for baseline pre-ablation imaging when the heart rate is highly variable – is very challenging, as is the rapid and automatic processing of the 3D LGE data.

This workshop will bring together imaging scientists, computer scientists, electrophysiologists and clinicians to discuss (1) what the electrophysiologist requires from MR, (2) how the relevant data can be acquired with the best quality possible and (3) how that large volume of data can be quickly and automatically processed to show and quantify ablation scarring. The state-of-the-art invited presentations will be followed by a panel discussion. A full program will be provided shortly.

Students and researchers working across the biomedical, computer and clinical sciences are invited to attend. They are also encouraged to submit a poster on any related work to the Hounsfield poster symposium which will be held immediately after the workshop and immediately prior to the 2015 Hounsfield Lecture, given this year by Professor Juergen Hennig of the University of Freiburg. Posters should be submitted via the Hounsfield Lecture website (closing date Friday 9th October).

Attendance at the workshop is free but please register (j.keegan@rbht.nhs.uk) in advance. 

Programme

Room 122 Sir Alexander Fleming Building, Imperial College London, Exhibition Road SW7 2AZ

Chairs: Dr Jenny Keegan and Professor David Firmin

2:15pm             Introduction to workshop, Professor David Firmin, Head of MR Physics, Royal Brompton Hospital, Professor of Biomedical Imaging, Imperial College London

2:25pm             What is EP trying to achieve and how can magnetic resonance imaging help? Dr Tom Wong, Consultant Electrophysiologist and Cardiologist, Royal Brompton Hospital

2:40pm             Magnetic resonance angiography (MRA) and 3D roadmap acquisitions, Dr Vivek Muthurangu, Head of Vascular Imaging and Physics, UCL Institute of Cardiovascular Science

2:55pm             3D late gadolinium enhancement (LGE) acquisition, Dr Jenny Keegan, Principal Physicist, Royal Brompton Hospital, Adjunct Reader, Imperial College London

3:10pm             Coffee Break

3:30pm             Automated left atrial segmentation, Dr Kawal Rhode, Reader in Biomedical Engineering, King’s College London

3:45pm             Automated classification of LGE, Dr Archontis Giannakidis, Image Analysis Physicist, Royal Brompton Hospital, Honorary Research Fellow, Imperial College London

4:00pm             Automated quantification of LGE – comparison of algorithms, Dr Rashed Karim, Research Fellow, King’s College London, Honorary Lecturer, Imperial College London

4:15pm             Combining MR and EP data, Dr James Harrison, Clinical Lecturer in Cardiology, King’s College London

4:30pm             Discussion

Contacts

Dr Jenny Keegan                                Professor David Firmin

j.keegan@rbht.nhs.uk                        d.firmin@imperial.ac.uk