# Atrial fibrillation ablation assessment and guidance using native-contrast T1 weighted MRI

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2021 · $782,684

## Abstract

Project Summary:
 Atrial fibrillation (Afib) is a common arrhythmia that is currently difficult to manage. Afib catheter
ablation is more effective than medical therapy for maintaining normal rhythm. However, treatment failure is
common, around 50% for persistent forms of Afib. Attempts to improve outcomes by performing more
extensive ablation have been limited by new arrhythmias, like atrial flutter, which can be caused by the
procedure. Outcomes can be improved by repeat procedures, but arrhythmia recurrence is still common.
Surgical procedures have higher success for treating Afib, but the successful techniques are prohibitively
invasive for treating most patients. Methods to improve the success of the first Afib catheter ablation
procedure are needed.
 Ablation failure is thought to be due to the inability to create properly placed, permanent ablation
lesions. Currently, transient tissue injury and edema caused by ablation can make ablation appear complete
at the end of the procedure. However, as transient injury resolves over days to weeks, arrhythmia can recur.
Current methods for determining whether ablation is finished cannot tell the difference between permanent
and transient tissue injury. Methods that show where additional ablation needs to be performed and confirm
that permanent ablation has been completed are expected to improve the success of Afib ablation.
 We have developed a non-contrast MRI method for seeing permanent ablation lesions. We recently
showed this method can see ablation lesions in the thin walled atrium, which is the part of the heart that
causes Afib. Because this method does not need intravenous contrast, it can be repeated during a procedure
until complete ablation is confirmed.
 This proposal will find out if this method can 1) detect sites of incomplete Afib ablation, 2) guide
additional ablation to these sites, and 3) confirm ablation is complete at the end of the procedure. This
proposal also translates this method, previously developed in animals, to patients undergoing Afib ablation.
 Effective acute assessment of ablative treatment would provide an important component of
feedback not currently available for procedure guidance. Successful completion of these aims will
introduce a new paradigm for confirming ablation completion in order to reduce arrhythmia recurrence
following AFib ablation. These methods could also be applied to other arrhythmias where incomplete
ablation contributes to poor ablation outcomes, like ventricular tachycardia.

## Key facts

- **NIH application ID:** 10182527
- **Project number:** 1R01HL157259-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Aravindan Kolandaivelu
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $782,684
- **Award type:** 1
- **Project period:** 2021-08-15 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10182527

## Citation

> US National Institutes of Health, RePORTER application 10182527, Atrial fibrillation ablation assessment and guidance using native-contrast T1 weighted MRI (1R01HL157259-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10182527. Licensed CC0.

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