Johannes T Kowallick1, Wieland Staab2, Andreas Schuster3, Sören J Backhaus4, Mark Weber-Krüger4, Lukas Bauer2, Christian Sohns5, Joachim Lotz2, Gerd Hasenfuß4, Lars Lüthje4, Markus Zabel4, Leonard Bergau4. 1. Institute for Diagnostic and Interventional Radiology, University Medical Centre Göttingen, Georg-August-University, Göttingen, Germany; DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany. Electronic address: johannes.kowallick@med.uni-goettingen.de. 2. Institute for Diagnostic and Interventional Radiology, University Medical Centre Göttingen, Georg-August-University, Göttingen, Germany; DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany. 3. DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany; Department of Cardiology and Pneumology, University Medical Centre Göttingen, Georg-August-University, Göttingen, Germany; Department of Cardiology, Royal North Shore Hospital, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, Australia. 4. DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany; Department of Cardiology and Pneumology, University Medical Centre Göttingen, Georg-August-University, Göttingen, Germany. 5. Electrophysiology Bremen, Heart Center Bremen, Bremen, Germany.
Abstract
BACKGROUND: Catheter ablation of atrial fibrillation (AF) improves left ventricular (LV) function in patients with LV systolic dysfunction, suggestive of underlying arrhythmia-induced adverse remodeling. OBJECTIVES: The objectives of this study were to evaluate whether arrhythmia-induced LV remodeling occurs in patients with AF and preserved LV systolic function and to assess whether this remodeling is reversible after restoration of sinus rhythm by catheter ablation. METHODS: Forty-three patients with AF and preserved LV systolic function (LV ejection fraction 62% ± 7%) underwent cardiovascular magnetic resonance (CMR) imaging before catheter ablation including native T1 mapping using a modified Look-Locker inversion recovery sequence. Twenty-five patients underwent follow-up CMR 3 months after catheter ablation. Twenty-two matched controls without AF underwent the same CMR protocol. RESULTS: Patients with AF had higher baseline LV native T1 values than did controls (1296 ± 55 ms vs 1243 ± 55 ms; P < .01). During a median follow-up of 9 months (interquartile range 4-14 months), 17 patients (40%) experienced AF recurrence. No differences in baseline T1 values were observed between patients with and without AF recurrence. There was a significant decrease in native T1 values in patients with successful restoration of sinus rhythm after catheter ablation at 3 months of follow-up CMR (1300 ± 45 ms vs 1270 ± 55 ms; P < .01), while they remain unchanged in patients with AF recurrence (1303 ± 51 ms vs 1309 ± 31 ms; P = .64). CONCLUSION: These preliminary results suggest that subclinical arrhythmia-induced LV structural remodeling occurs in patients with AF and preserved LV systolic function. This remodeling might be reversible after catheter ablation with successful restoration of sinus rhythm as quantified noninvasively and gadolinium-free by CMR native T1 mapping.
BACKGROUND: Catheter ablation of atrial fibrillation (AF) improves left ventricular (LV) function in patients with LV systolic dysfunction, suggestive of underlying arrhythmia-induced adverse remodeling. OBJECTIVES: The objectives of this study were to evaluate whether arrhythmia-induced LV remodeling occurs in patients with AF and preserved LV systolic function and to assess whether this remodeling is reversible after restoration of sinus rhythm by catheter ablation. METHODS: Forty-three patients with AF and preserved LV systolic function (LV ejection fraction 62% ± 7%) underwent cardiovascular magnetic resonance (CMR) imaging before catheter ablation including native T1 mapping using a modified Look-Locker inversion recovery sequence. Twenty-five patients underwent follow-up CMR 3 months after catheter ablation. Twenty-two matched controls without AF underwent the same CMR protocol. RESULTS:Patients with AF had higher baseline LV native T1 values than did controls (1296 ± 55 ms vs 1243 ± 55 ms; P < .01). During a median follow-up of 9 months (interquartile range 4-14 months), 17 patients (40%) experienced AF recurrence. No differences in baseline T1 values were observed between patients with and without AF recurrence. There was a significant decrease in native T1 values in patients with successful restoration of sinus rhythm after catheter ablation at 3 months of follow-up CMR (1300 ± 45 ms vs 1270 ± 55 ms; P < .01), while they remain unchanged in patients with AF recurrence (1303 ± 51 ms vs 1309 ± 31 ms; P = .64). CONCLUSION: These preliminary results suggest that subclinical arrhythmia-induced LV structural remodeling occurs in patients with AF and preserved LV systolic function. This remodeling might be reversible after catheter ablation with successful restoration of sinus rhythm as quantified noninvasively and gadolinium-free by CMR native T1 mapping.
Authors: Leonard Bergau; Philipp Bengel; Vanessa Sciacca; Thomas Fink; Christian Sohns; Philipp Sommer Journal: J Clin Med Date: 2022-04-29 Impact factor: 4.964
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Authors: Darius Dabir; Thomas M Vollbrecht; Julian A Luetkens; Daniel L R Kuetting; Alexander Isaak; Andreas Feisst; Rolf Fimmers; Alois M Sprinkart; Hans H Schild; Daniel Thomas Journal: J Cardiovasc Magn Reson Date: 2019-08-29 Impact factor: 5.364
Authors: Christian Sohns; Nassir F Marrouche; Angelika Costard-Jäckle; Samuel Sossalla; Leonard Bergau; Rene Schramm; Uwe Fuchs; Hazem Omran; Kerstin Rubarth; Daniel Dumitrescu; Frank Konietschke; Volker Rudolph; Jan Gummert; Philipp Sommer; Henrik Fox Journal: ESC Heart Fail Date: 2020-12-13