Suvai Gunasekaran1,2, Daniel C Lee3, Bradley P Knight3, Jeremy D Collins1,4, Lexiaozi Fan1,2, Amar Trivedi3, Ann B Ragin1, James C Carr1, Rod S Passman3, Daniel Kim1,2. 1. Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois. 2. Department of Biomedical Engineering, Northwestern University, Evanston, Illinois. 3. Division of Cardiology, Department of Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. 4. Department of Radiology, Mayo Clinic, Rochester, Minnesota.
Abstract
INTRODUCTION: A recent study reported that diffuse left ventricular (LV) fibrosis is a predictor of atrial fibrillation (AF) recurrence following catheter ablation, by measuring postcontrast cardiac T1 (an error prone metric as per the 2017 Society for Cardiovascular Magnetic Resonance consensus statement) using an inversion-recovery pulse sequence (an error prone method in arrhythmia) in AF ablation candidates. The purpose of this study was to verify the prior study, by measuring extracellular volume (ECV) fraction (an accurate metric) using a saturation-recovery pulse sequence (accurate method in arrhythmia). METHODS AND RESULTS: This study examined 100 AF patients (mean age = 62 ± 11 years, 69 males and 31 females, 67 paroxysmal [pAF] and 33 persistent [peAF]) who underwent a preablation cardiovascular magnetic resonance (CMR) exam. LV ECV and left atrial (LA) and LV functional parameters were quantified using standard analysis methods. During an average follow-up period of 457 ± 261 days with 4 ± 3 rhythm checks per patient, 72 patients maintained sinus rhythm. Between those who maintained sinus rhythm (n = 72) and those who reverted to AF (n = 28), the only clinical characteristic that was significantly different was age (60 ± 12 years vs 66 ± 9 years); for CMR metrics, neither mean LV ECV (25.1 ± 3.3% vs 24.7 ± 3.7%), native LV T1 (1093.8 ± 73.5 ms vs 1070.2 ± 115.9 ms), left ventricular ejection fraction (54.1 ± 11.2% vs 55.7 ± 7.1%), nor LA end diastolic volume/body surface area (42.4 ± 14.8 mL/m2 vs 43.4 ± 19.6 mL/m2 ) were significantly different (P ≥ .23). According to Cox regression tests, none of the clinical and imaging variables predict AF recurrence. CONCLUSION: Neither LV ECV nor other CMR metrics predict recurrence of AF following catheter ablation.
INTRODUCTION: A recent study reported that diffuse left ventricular (LV) fibrosis is a predictor of atrial fibrillation (AF) recurrence following catheter ablation, by measuring postcontrast cardiac T1 (an error prone metric as per the 2017 Society for Cardiovascular Magnetic Resonance consensus statement) using an inversion-recovery pulse sequence (an error prone method in arrhythmia) in AF ablation candidates. The purpose of this study was to verify the prior study, by measuring extracellular volume (ECV) fraction (an accurate metric) using a saturation-recovery pulse sequence (accurate method in arrhythmia). METHODS AND RESULTS: This study examined 100 AFpatients (mean age = 62 ± 11 years, 69 males and 31 females, 67 paroxysmal [pAF] and 33 persistent [peAF]) who underwent a preablation cardiovascular magnetic resonance (CMR) exam. LV ECV and left atrial (LA) and LV functional parameters were quantified using standard analysis methods. During an average follow-up period of 457 ± 261 days with 4 ± 3 rhythm checks per patient, 72 patients maintained sinus rhythm. Between those who maintained sinus rhythm (n = 72) and those who reverted to AF (n = 28), the only clinical characteristic that was significantly different was age (60 ± 12 years vs 66 ± 9 years); for CMR metrics, neither mean LV ECV (25.1 ± 3.3% vs 24.7 ± 3.7%), native LV T1 (1093.8 ± 73.5 ms vs 1070.2 ± 115.9 ms), left ventricular ejection fraction (54.1 ± 11.2% vs 55.7 ± 7.1%), nor LA end diastolic volume/body surface area (42.4 ± 14.8 mL/m2 vs 43.4 ± 19.6 mL/m2 ) were significantly different (P ≥ .23). According to Cox regression tests, none of the clinical and imaging variables predict AF recurrence. CONCLUSION: Neither LV ECV nor other CMR metrics predict recurrence of AF following catheter ablation.
Authors: Zachary M Gertz; Amresh Raina; Laszlo Saghy; Erica S Zado; David J Callans; Francis E Marchlinski; Martin G Keane; Frank E Silvestry Journal: J Am Coll Cardiol Date: 2011-09-27 Impact factor: 24.094
Authors: Mark A Griswold; Peter M Jakob; Robin M Heidemann; Mathias Nittka; Vladimir Jellus; Jianmin Wang; Berthold Kiefer; Axel Haase Journal: Magn Reson Med Date: 2002-06 Impact factor: 4.668
Authors: Bernard J Gersh; Barry J Maron; Robert O Bonow; Joseph A Dearani; Michael A Fifer; Mark S Link; Srihari S Naidu; Rick A Nishimura; Steve R Ommen; Harry Rakowski; Christine E Seidman; Jeffrey A Towbin; James E Udelson; Clyde W Yancy Journal: J Thorac Cardiovasc Surg Date: 2011-12 Impact factor: 5.209
Authors: Craig T January; L Samuel Wann; Joseph S Alpert; Hugh Calkins; Joaquin E Cigarroa; Joseph C Cleveland; Jamie B Conti; Patrick T Ellinor; Michael D Ezekowitz; Michael E Field; Katherine T Murray; Ralph L Sacco; William G Stevenson; Patrick J Tchou; Cynthia M Tracy; Clyde W Yancy Journal: J Am Coll Cardiol Date: 2014-03-28 Impact factor: 24.094
Authors: Michelle Fitts; Elodie Breton; Eugene G Kholmovski; Derek J Dosdall; Sathya Vijayakumar; Kyung P Hong; Ravi Ranjan; Nassir F Marrouche; Leon Axel; Daniel Kim Journal: Magn Reson Med Date: 2012-12-27 Impact factor: 4.668
Authors: Daniel R Messroghli; James C Moon; Vanessa M Ferreira; Lars Grosse-Wortmann; Taigang He; Peter Kellman; Julia Mascherbauer; Reza Nezafat; Michael Salerno; Erik B Schelbert; Andrew J Taylor; Richard Thompson; Martin Ugander; Ruud B van Heeswijk; Matthias G Friedrich Journal: J Cardiovasc Magn Reson Date: 2017-10-09 Impact factor: 5.364