Document Detail

Echocardiographic left atrial reverse remodeling after catheter ablation of atrial fibrillation is predicted by preablation delayed enhancement of left atrium by magnetic resonance imaging.
MedLine Citation:
PMID:  21095275     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Atrial fibrosis is a hallmark of atrial structural remodeling (SRM) and leads to structural and functional impairment of left atrial (LA) and persistence of atrial fibrillation (AF). This study was conducted to assess LA reverse remodeling after catheter ablation of AF in mild and moderate-severe LA SRM.
METHODS: Catheter ablation was performed in 68 patients (age 62 ± 14 years, 68% males) with paroxysmal (n = 26) and persistent (n = 42) AF. The patients were divided into group 1 with mild LA SRM (<10%, n = 31) and group 2 with moderate-severe LA SRM (>10%, n = 37) by delayed enhancement magnetic resonance imaging (DEMRI). Two-dimensional echocardiography, LA strain, and strain rate during left ventricular systole by velocity vector imaging were performed pre and at 6 ± 3 months postablation. The long-term outcome was monitored for 12 months.
RESULTS: Patients in group 1 were younger (57 ± 15 vs 66 ± 13 years, P = .009) with a male predominance (80% vs 57%, P < .05) as compared to group 2. Postablation, group 1 had significant increase in average LA strain (Δ↑: 14% vs 4%, P < .05) and strain rate (Δ↑: 0.5 vs 0.1 cm/s, P < .05) as compared to group 2. There was a trend toward more patients with persistent AF in group 2 (68% vs 55%, P = .2), but it was not statistically significant. Group 2 had more AF recurrences (41% vs 16%, P = .02) at 12 months after ablation.
CONCLUSION: Mild preablation LA SRM by DEMRI predicts favorable LA structural and functional reverse remodeling and long-term success after catheter ablation of AF, irrespective of the paroxysmal or persistent nature of AF.
Suman S Kuppahally; Nazem Akoum; Troy J Badger; Nathan S Burgon; Thomas Haslam; Eugene Kholmovski; Rob Macleod; Christopher McGann; Nassir F Marrouche
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  160     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-18     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  877-84     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Mosby, Inc. All rights reserved.
Division of Cardiology, University of Utah, Salt Lake City, UT, USA.
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MeSH Terms
Atrial Fibrillation / diagnosis,  physiopathology,  surgery*
Atrial Function, Left / physiology*
Catheter Ablation / methods*
Cross-Sectional Studies
Echocardiography, Doppler, Color / methods*
Follow-Up Studies
Heart Atria / pathology,  physiopathology,  ultrasonography*
Image Enhancement
Magnetic Resonance Imaging / methods*
Middle Aged
Preoperative Care / methods
Prospective Studies
Severity of Illness Index
Ventricular Remodeling / physiology*
Grant Support
5P41RR012553-02/RR/NCRR NIH HHS; P41 RR012553/RR/NCRR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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