BACKGROUND: The extent of left atrial (LA) late gadolinium enhancement (LGE), as a surrogate for fibrosis, has been associated with atrial fibrillation (AF) recurrence after catheter ablation. Furthermore, there is ex vivo evidence that islands of fibrosis may anchor fibrillatory rotors. OBJECTIVE: The purpose of this study was to examine the anatomical association of AF rotors with LA and right atrial (RA) LGE on cardiac magnetic resonance. METHODS: The cohort included 9 patients with persistent AF (mean age 61.1 ± 9.7 years) who underwent LGE cardiac magnetic resonance before AF ablation using the focal impulse and rotor modulation system. The extent of LA and RA LGE was quantified globally and in each of the 7 sectors: LA posterior/inferior wall, anterior wall, roof, left and right pulmonary vein antra, and RA lateral and septal regions. The multivariable association of rotor incidence with global and per sector LGE extent was examined using multivariable Bernoulli logistic regression estimated by generalized estimating equations. RESULTS: The mean RA and LA volumes were 113.2 ± 37.31 and 143.03 ± 58.25 mL, respectively. The mean RA and LA LGE burden was 17.2% ± 11.0% and 17.4% ± 14.4%, respectively. A total of 18 LA rotors and 9 RA rotors were identified in all patients. No univariable or multivariable association was observed between global or per sector LGE extent and focal impulse and rotor modulation rotor incidence. CONCLUSION: In this cohort of patients, there was no association between AF rotor incidence and the global or regional extent of RA and LA LGE.
BACKGROUND: The extent of left atrial (LA) late gadolinium enhancement (LGE), as a surrogate for fibrosis, has been associated with atrial fibrillation (AF) recurrence after catheter ablation. Furthermore, there is ex vivo evidence that islands of fibrosis may anchor fibrillatory rotors. OBJECTIVE: The purpose of this study was to examine the anatomical association of AF rotors with LA and right atrial (RA) LGE on cardiac magnetic resonance. METHODS: The cohort included 9 patients with persistent AF (mean age 61.1 ± 9.7 years) who underwent LGE cardiac magnetic resonance before AF ablation using the focal impulse and rotor modulation system. The extent of LA and RA LGE was quantified globally and in each of the 7 sectors: LA posterior/inferior wall, anterior wall, roof, left and right pulmonary vein antra, and RA lateral and septal regions. The multivariable association of rotor incidence with global and per sector LGE extent was examined using multivariable Bernoulli logistic regression estimated by generalized estimating equations. RESULTS: The mean RA and LA volumes were 113.2 ± 37.31 and 143.03 ± 58.25 mL, respectively. The mean RA and LA LGE burden was 17.2% ± 11.0% and 17.4% ± 14.4%, respectively. A total of 18 LA rotors and 9 RA rotors were identified in all patients. No univariable or multivariable association was observed between global or per sector LGE extent and focal impulse and rotor modulation rotor incidence. CONCLUSION: In this cohort of patients, there was no association between AF rotor incidence and the global or regional extent of RA and LA LGE.
Authors: Brian J Hansen; Jichao Zhao; Ning Li; Alexander Zolotarev; Stanislav Zakharkin; Yufeng Wang; Josh Atwal; Anuradha Kalyanasundaram; Suhaib H Abudulwahed; Katelynn M Helfrich; Anna Bratasz; Kimerly A Powell; Bryan Whitson; Peter J Mohler; Paul M L Janssen; Orlando P Simonetti; John D Hummel; Vadim V Fedorov Journal: JACC Clin Electrophysiol Date: 2018-11-01
Authors: Uma Mahesh R Avula; Jeffrey Abrams; Alexander Katchman; Sergey Zakharov; Sergey Mironov; Joseph Bayne; Daniel Roybal; Anirudh Gorti; Lin Yang; Vivek Iyer; Marc Waase; Deepak Saluja; Edward J Ciaccio; Hasan Garan; Andrew R Marks; Steven O Marx; Elaine Y Wan Journal: JCI Insight Date: 2019-04-25
Authors: Tarek Zghaib; Ali Keramati; Jonathan Chrispin; Dong Huang; Muhammad A Balouch; Luisa Ciuffo; Ronald D Berger; Joseph E Marine; Hiroshi Ashikaga; Hugh Calkins; Saman Nazarian; David D Spragg Journal: JACC Clin Electrophysiol Date: 2017-12-20
Authors: Caroline H Roney; Jason D Bayer; Sohail Zahid; Marianna Meo; Patrick M J Boyle; Natalia A Trayanova; Michel Haïssaguerre; Rémi Dubois; Hubert Cochet; Edward J Vigmond Journal: Europace Date: 2016-12 Impact factor: 5.214
Authors: Hubert Cochet; Rémi Dubois; Seigo Yamashita; Nora Al Jefairi; Benjamin Berte; Jean-Marc Sellal; Darren Hooks; Antonio Frontera; Sana Amraoui; Adlane Zemoura; Arnaud Denis; Nicolas Derval; Frederic Sacher; Olivier Corneloup; Valérie Latrabe; Stéphanie Clément-Guinaudeau; Jatin Relan; Sohail Zahid; Patrick M Boyle; Natalia A Trayanova; Olivier Bernus; Michel Montaudon; François Laurent; Mélèze Hocini; Michel Haïssaguerre; Pierre Jaïs Journal: JACC Clin Electrophysiol Date: 2017-11-06