Relation of Left Atrial Appendage Remodeling by Magnetic Resonance Imaging and Outcome of Ablation for Atrial Fibrillation

Relation of Left Atrial Appendage Remodeling by Magnetic Resonance Imaging and Outcome of... The left atrial appendage (LAA) is a nonpulmonary vein trigger site in atrial fibrillation (AF). The association of LAA structural remodeling (SRM) identified by late gadolinium enhancement magnetic resonance imaging (LGE-MRI) and AF ablation outcome has never been described. This study sought to investigate the clinical significance of LAA-SRM in AF patients who undergo ablation therapy. Consecutive patients with AF who underwent catheter ablation therapy within 14 days following MRI scan were included in this study. LAA-SRM was assessed using LGE-MRI images to quantify the extent of LAA-LGE. Patients were followed for arrhythmia recurrence after the ablation procedure. A total of 74 patients were included in the study, 68% were male, with a mean age of 72 years. Mean LAA-LGE extent was 9%. There were 37 arrhythmia recurrences (50%) observed over a mean follow-up period of 18 months. The recurrence rate was significantly higher (73.3% vs 37.5%; p = 0.045) in patients with LAA-LGE extent in the highest tier (T4) compared with the lowest tier (T1). LAA-LGE extent was independently associated with arrhythmia recurrence (adjusted hazard ratio [HR] 1.054; 95% confidence interval [CI] 1.008 to 1.103). In addition, there was an approximately fourfold increased risk of arrhythmia recurrence (adjusted HR 4.117, 95% CI 1.260 to 13.459) in patients with advanced LAA-SRM (T4 vs T1). In conclusion, the extent of LAA-SRM identified by LGE-MRI is associated with arrhythmia recurrence after AF ablation. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The American Journal of Cardiology Elsevier

Relation of Left Atrial Appendage Remodeling by Magnetic Resonance Imaging and Outcome of Ablation for Atrial Fibrillation

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Publisher
Elsevier
Copyright
Copyright © 2018 Elsevier Inc.
ISSN
0002-9149
D.O.I.
10.1016/j.amjcard.2018.03.027
Publisher site
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Abstract

The left atrial appendage (LAA) is a nonpulmonary vein trigger site in atrial fibrillation (AF). The association of LAA structural remodeling (SRM) identified by late gadolinium enhancement magnetic resonance imaging (LGE-MRI) and AF ablation outcome has never been described. This study sought to investigate the clinical significance of LAA-SRM in AF patients who undergo ablation therapy. Consecutive patients with AF who underwent catheter ablation therapy within 14 days following MRI scan were included in this study. LAA-SRM was assessed using LGE-MRI images to quantify the extent of LAA-LGE. Patients were followed for arrhythmia recurrence after the ablation procedure. A total of 74 patients were included in the study, 68% were male, with a mean age of 72 years. Mean LAA-LGE extent was 9%. There were 37 arrhythmia recurrences (50%) observed over a mean follow-up period of 18 months. The recurrence rate was significantly higher (73.3% vs 37.5%; p = 0.045) in patients with LAA-LGE extent in the highest tier (T4) compared with the lowest tier (T1). LAA-LGE extent was independently associated with arrhythmia recurrence (adjusted hazard ratio [HR] 1.054; 95% confidence interval [CI] 1.008 to 1.103). In addition, there was an approximately fourfold increased risk of arrhythmia recurrence (adjusted HR 4.117, 95% CI 1.260 to 13.459) in patients with advanced LAA-SRM (T4 vs T1). In conclusion, the extent of LAA-SRM identified by LGE-MRI is associated with arrhythmia recurrence after AF ablation.

Journal

The American Journal of CardiologyElsevier

Published: Jul 1, 2018

References

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