BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

*Contrast Media, Catheter Ablation/*methods, Echocardiography, Three-Dimensional/*methods, Female, Humans, Male, Middle aged, Prognosis, Prospective Studies, Single-Blind Method, Tachycardia, Supraventricular/complications/*surgery/*ultrasonography, Treatment Outcome, Ventricular Dysfunction, Left/etiology/*surgery/*ultrasonography,
Cardiovascular Ultrasound
Erasmus MC: University Medical Center Rotterdam

Szili-Török, T, Kimman, G-J.P, Scholten, M.F, Thornton, A.S, ten Cate, F.J, Roelandt, J.R.T.C, & Jordaens, L.J.L.M. (2004). Ablation lesions in Koch's triangle assessed by three-dimensional myocardial contrast echocardiography. Cardiovascular Ultrasound, 2. doi:10.1186/1476-7120-2-27