Journal article
Atrial Fibrosis by Late Gadolinium Enhancement Magnetic Resonance Imaging and Catheter Ablation of Atrial Fibrillation: 5-Year Follow-Up Data
Journal of the American Heart Association, Vol.7(23), pp.e006313-e006313
12/04/2018
DOI: 10.1161/JAHA.117.006313
PMCID: PMC6405558
PMID: 30511895
Abstract
Background-Late gadolinium enhancement magnetic resonance imaging is an effective tool for assessment of atrial fibrosis. The degree of left atrial fibrosis is a good predictor of atrial fibrillation (AF) ablation success at 1 year, but the association between left atrial fibrosis and long-term ablation success has not been studied.
Methods and Results-Late gadolinium enhancement magnetic resonance images of sufficient quality to quantify atrial fibrosis were obtained before the first AF ablation in 308 consecutive patients. Left atrial fibrosis was classified in 4 Utah stages (I, 0-10%; II, 10-20%; III, 20-30%; and IV, >30%). Patientswere followed up for up to 5 years until the time of first arrhythmia recurrence or second ablation. A total of 308 patients were included; the mean age was 64.5 +/- 12.1 years, and 63.4% were men. During follow-up, 157 patients experienced an arrhythmia recurrence and 106 patients underwent a repeated ablation. A graded effect was observed in which patients with more advanced atrial fibrosis were more likely to experience recurrent AF (hazard ratio for stage IV versus stage I, 2.73; 95% confidence interval, 1.57-4.75) and undergo a repeated ablation (proportional odds ratio for stage IV versus stage I, 5.19; 95% confidence interval, 2.12-12.69).
Conclusions-The degree of left atrial fibrosis predicts the success of AF ablation at up to 5 years follow-up. In patients with advanced atrial fibrosis, AF ablation is associated with a high procedural failure rate.
Details
- Title: Subtitle
- Atrial Fibrosis by Late Gadolinium Enhancement Magnetic Resonance Imaging and Catheter Ablation of Atrial Fibrillation: 5-Year Follow-Up Data
- Creators
- Mihail G. Chelu - Research ManagementJordan B. King - Kaiser PermanenteEugene G. Kholmovski - University of UtahJunjie Ma - University of UtahPim Gal - Research ManagementQussay Marashly - University of UtahMossab A. AlJuaid - University of UtahGagandeep Kaur - Research ManagementMichelle A. Silver - University of UtahKara A. Johnson - Research ManagementPromporn Suksaranjit - University of UtahBrent D. Wilson - University of UtahFrederick T. Han - University of UtahArif Elvan - University of UtahNassir F. Marrouche - University of Utah
- Resource Type
- Journal article
- Publication Details
- Journal of the American Heart Association, Vol.7(23), pp.e006313-e006313
- Publisher
- Wiley
- DOI
- 10.1161/JAHA.117.006313
- PMID
- 30511895
- PMCID
- PMC6405558
- ISSN
- 2047-9980
- eISSN
- 2047-9980
- Number of pages
- 10
- Language
- English
- Date published
- 12/04/2018
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984359878502771
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