Literature DB >> 31867751

Left atrial fibrosis progression detected by LGE-MRI after ablation of atrial fibrillation.

Mobin Kheirkhahan1, Alex Baher1,2, Matin Goldooz3, Eugene G Kholmovski1,3,4, Alan K Morris1, Ibolya Csecs1, Mihail G Chelu1,2, Brent D Wilson2,3, Nassir F Marrouche1,2.   

Abstract

BACKGROUND: Left atrial (LA) fibrosis is thought to be a substrate for atrial fibrillation (AF) and can be quantified by late gadolinium enhancement magnetic resonance imaging (LGE-MRI). Fibrosis formation in LA is a dynamic process and may either progress or regress following AF ablation. We examined the impact of postablation progression in LA fibrosis on AF recurrence.
METHODS: LA enhancement in LGE-MRI was quantified in 127 consecutive patients who underwent first time AF ablation. Serial LGE-MRIs were done prior to AF ablation, 3 months postablation and at least 12 months after second LGE-MRI. Transient postablation lesion (TL) was defined as atrial enhancement caused by ablation lesions that was detected on the first (3 month) but not on the second postablation LGE-MRI. New fibrosis (NF) was defined as atrial enhancement detected on the most recent LGE-MRI, at least 15 months after the ablation procedure. AF recurrence and its correlation with TL and NF was assessed in all patients during the follow-up period.
RESULTS: An increase of 1% NF increased the chance of postablation AF recurrence by 3% (hazard ratio [HR] 1.03, 95% CI 1-1.06, P = .05). TL had no significant impact on recurrence (P = .057). After adjusting for cardiovascular risk factors, HR increased as NF became greater. Greater volume of NF (≥21%) corresponded with lower arrhythmia-free survival (37% vs 62%, P = .01).
CONCLUSION: NF formation postablation of AF is a novel marker of long-term procedural outcome. Extensive NF is associated with significantly higher risk of atrial arrhythmia recurrence.
© 2019 Wiley Periodicals, Inc.

Entities:  

Keywords:  LGE-MRI; ablation; atrial fibrillation; atrial fibrosis; atrial fibrosis progression

Mesh:

Substances:

Year:  2020        PMID: 31867751     DOI: 10.1111/pace.13866

Source DB:  PubMed          Journal:  Pacing Clin Electrophysiol        ISSN: 0147-8389            Impact factor:   1.976


  8 in total

1.  Effect of MRI-Guided Fibrosis Ablation vs Conventional Catheter Ablation on Atrial Arrhythmia Recurrence in Patients With Persistent Atrial Fibrillation: The DECAAF II Randomized Clinical Trial.

Authors:  Nassir F Marrouche; Oussama Wazni; Christopher McGann; Tom Greene; J Michael Dean; Lilas Dagher; Eugene Kholmovski; Moussa Mansour; Francis Marchlinski; David Wilber; Gerhard Hindricks; Christian Mahnkopf; Darryl Wells; Pierre Jais; Prashanthan Sanders; Johannes Brachmann; Jeroen J Bax; Leonie Morrison-de Boer; Thomas Deneke; Hugh Calkins; Christian Sohns; Nazem Akoum
Journal:  JAMA       Date:  2022-06-21       Impact factor: 157.335

2.  Higher serum sST2 is associated with increased left atrial low-voltage areas and atrial fibrillation recurrence in patients undergoing radiofrequency ablation.

Authors:  Jiali Fan; Yuan Li; Qing Yan; Wenhuan Wu; Pan Xu; Lu Liu; Chunhong Luan; Juanli Zhang; Qiangsun Zheng; Jiahong Xue
Journal:  J Interv Card Electrophysiol       Date:  2022-02-17       Impact factor: 1.759

Review 3.  Cardiac MRI to Manage Atrial Fibrillation.

Authors:  Yan Zhao; Lilas Dagher; Chao Huang; Peter Miller; Nassir F Marrouche
Journal:  Arrhythm Electrophysiol Rev       Date:  2020-12

4.  The Effects of Fibrotic Cell Type and Its Density on Atrial Fibrillation Dynamics: An In Silico Study.

Authors:  Laura C Palacio; Juan P Ugarte; Javier Saiz; Catalina Tobón
Journal:  Cells       Date:  2021-10-15       Impact factor: 6.600

5.  Optimal Ablation Settings Predicting Durable Scar Detected Using LGE-MRI after Modified Left Atrial Anterior Line Ablation.

Authors:  Mathias Forkmann; Christian Mahnkopf; Marcel Mitlacher; Marc Wolff; Beatriz Tose Costa Paiva; Sonia Busch
Journal:  J Clin Med       Date:  2022-02-04       Impact factor: 4.241

Review 6.  Ablation Lesion Assessment with MRI.

Authors:  Lluís Mont; Ivo Roca-Luque; Till F Althoff
Journal:  Arrhythm Electrophysiol Rev       Date:  2022-04

7.  Effect of DrOnedarone on atrial fibrosis progression and atrial fibrillation recurrence postablation: Design of the EDORA randomized clinical trial.

Authors:  Nassir F Marrouche; Lilas Dagher; Oussama Wazni; Nazem Akoum; Moussa Mansour; Abdel Hadi El Hajjar; Arezu Bhatnagar; He Hua
Journal:  J Cardiovasc Electrophysiol       Date:  2021-11-02       Impact factor: 2.942

8.  Serum-Soluble ST2 Is a Novel Biomarker for Evaluating Left Atrial Low-Voltage Zone in Paroxysmal Atrial Fibrillation.

Authors:  Zefeng Wang; Liting Cheng; Junmeng Zhang; Zhuo Liang; Ruiqing Dong; Fei Hang; Xinlu Wang; Ziyu Wang; Yongquan Wu; Jie Du
Journal:  Med Sci Monit       Date:  2020-09-08
  8 in total

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