Feasibility study: Characterizing acute lesion dimensions in patients with and without devices using noncontrast (native T1-weighted) magnetic resonance imaging after ventricular tachycardia/premature ventricular complex radiofrequency ablation
Bibliographic record
Abstract
Background Late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) has been shown to reliably locate RFA lesions with microvascular obstruction (MVO) as a broadly accepted signature. However, MVO volume depends on the time elapsed after gadolinium contrast injection . Native T 1 w MRI has recently been shown to accurately characterize RFA lesions in preclinical models. Objective To demonstrate the feasibility of wideband native T 1 w MRI in characterizing lesion dimensions in patients within 7-days of ventricular tachycardia (VT) radiofrequency ablation (RFA). Methods Post-ablation wideband native T 1 w and 3D LGE MRI was performed within 7-days of RFA. RFA lesion surface area (mm 2 ), volume (mm 3 ), and native T 1 w maximum lesion depth were calculated. Average catheter contact force (g), ablation duration (s) and impedance drop (Ω) were calculated. Patients with and without implantable cardioverter defibrillators (ICDs) were included. Results 10 patients (median age 64.5 years, 60% ischemic) underwent VT RFA (80% endocardial, 20% epicardial RFA), and post-ablation cardiac MRI within 7-days of RFA (median 4.5 days). There was a significantly greater mean MVO surface area and volume compared to mean native T 1 w lesion surface area and volume (p=0.0108, p=0.0376; p<0.05), respectively. There were strong positive correlations between average surface area and average volume measured by MVO and native T 1 w (r=0.71, p=0.0237; r=0.70, p=0.0265; p<0.05), respectively. Average maximum native T 1 w lesion depth correlated with average ablation duration and average impedance drop (r=0.73, p=0.02; r=0.68, p=0.04, p<0.05), respectively. Conclusion Native T 1 w MRI can effectively characterize lesion dimensions in patients with and without ICDs within 7 days post-ablation. This emerging biomarker may facilitate early prediction of RFA efficacy and ablation success particularly in patients demonstrating contraindications to gadolinium contrast agents.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".