Journal article
Incidental LV LGE on CMR Imaging in Atrial Fibrillation Predicts Recurrence After Ablation Therapy
JACC. Cardiovascular imaging, Vol.8(7), pp.793-800
07/2015
DOI: 10.1016/j.jcmg.2015.03.008
PMID: 26093929
Abstract
This study sought to evaluate the prognostic significance of left ventricular late gadolinium enhancement (LV-LGE) incidentally found in atrial fibrillation (AF) patients who undergo ablation therapy.
LV-LGE provides prognostic information in patients with ischemic and nonischemic cardiomyopathies. However, data on the clinical significance of incidental LV-LGE in the AF population are limited.
A total of 778 patients who were referred for radiofrequency ablation of AF underwent cardiac magnetic resonance examinations between June 2006 and January 2013. Patients with a history of myocardial infarction or ablation therapy were excluded. The presence of LV-LGE was assessed by experienced imaging physicians. Patients were followed for arrhythmia recurrence after the radiofrequency ablation procedure.
Of 598 patients included in the study, 60% were men with a mean age of 64 years and a median AF duration of 25 months. LV-LGE was detected in 39 patients (6.5%). There were 240 arrhythmia recurrences observed involving 40% of patients over a median follow-up period of 52 months. On univariate analysis, age (hazard ratio [HR]: 1.02; 95% confidence interval [CI]: 1.00 to 1.03), male sex (HR: 0.63; 95% CI: 0.47 to 0.86), diabetes (HR: 1.53; 95% CI: 1.03 to 2.27), CHADS2 score (HR: 1.19; 95% CI: 1.04 to 1.36), CHA2DS2-VASc score (HR: 1.18; 95% CI: 1.08 to 1.30), left atrial (LA) fibrosis (HR: 1.66; 95% CI: 1.41 to 1.96), LV-LGE (HR: 1.83; 95% CI: 1.11 to 3.03), persistent AF (HR: 1.52; 95% CI: 1.11 to 2.09), and LA area (HR: 1.03; 95% CI: 1.01 to 1.05) were significantly associated with arrhythmia recurrence. The recurrence rate was 69% in patients with LV-LGE compared with 38% in patients without LV-LGE (p < 0.001). In a multivariate model, LA fibrosis and LV-LGE were independent predictors of arrhythmia recurrence.
In AF patients without history of myocardial infarction, LV-LGE is a significant independent predictor of arrhythmia recurrence after ablation therapy.
Details
- Title: Subtitle
- Incidental LV LGE on CMR Imaging in Atrial Fibrillation Predicts Recurrence After Ablation Therapy
- Creators
- Promporn Suksaranjit - University of UtahNazem Akoum - University of UtahEugene G. Kholmovski - University of UtahGregory J. Stoddard - University of UtahLowell Chang - University of UtahKavitha Damal - University of UtahKrishna Velagapudi - University of UtahAllen Rassa - University of UtahErik Bieging - University of UtahShridhar Challa - University of UtahImran Haider - University of UtahNassir F. Marrouche - University of UtahChristopher J. McGann - University of UtahBrent D. Wilson - University of Utah
- Resource Type
- Journal article
- Publication Details
- JACC. Cardiovascular imaging, Vol.8(7), pp.793-800
- DOI
- 10.1016/j.jcmg.2015.03.008
- PMID
- 26093929
- NLM abbreviation
- JACC Cardiovasc Imaging
- ISSN
- 1936-878X
- eISSN
- 1876-7591
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 07/2015
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984359677102771
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