Document Detail


Evaluation of the left atrial substrate in patients with lone atrial fibrillation using delayed-enhanced MRI: implications for disease progression and response to catheter ablation.
MedLine Citation:
PMID:  20601148     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Lone atrial fibrillation (AF) is thought to be a benign type or an early stage of the disease.
OBJECTIVE: This study sought to compare the left atrium (LA) substrate using delayed-enhanced magnetic resonance imaging (DE-MRI) in patients with lone AF versus those with comorbidities.
METHODS: Forty of 333 included patients met criteria for lone AF. All patients underwent DE-MRI to quantify atrial fibrosis as a marker for structural remodeling (SRM) and underwent catheter ablation. Based on the degree of SRM, patients were staged into 4 groups: Utah I (≤5% LA wall enhancement), Utah II (>5% to ≤20%), Utah III (>20% to ≤35%), or Utah IV (>35%).
RESULTS: Distribution in Utah I to IV was comparable in patients with lone AF and non-lone AF. In both groups, a number of patients showed extensive SRM. Mean enhancement (14.08 ± 8.94 vs. 16.94 ± 11.37) was not significantly different between the 2 groups (P = .0721). In the lone AF group, catheter ablation was successful in suppressing AF in all of Utah I, 81.82% of Utah II, 62.5% of Utah III, and none of Utah IV patients. Similar results were achieved in the non-lone AF group. Outcome after ablation was significantly dependent on the SRM of the LA (P < .001).
CONCLUSION: The degree of LA structural remodeling as detected using DE-MRI is independent of AF type and associated comorbidities. Selecting appropriate treatment candidates based on the quality and quantity of atrial fibrosis using DE-MRI would improve procedural outcome and avoid unnecessary intervention.
Authors:
Christian Mahnkopf; Troy J Badger; Nathan S Burgon; Marcos Daccarett; Thomas S Haslam; Christopher T Badger; Christopher J McGann; Nazem Akoum; Eugene Kholmovski; Rob S Macleod; Nassir F Marrouche
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-01
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  7     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-27     Completed Date:  2011-02-04     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1475-81     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Affiliation:
Comprehensive Arrhythmia and Research Management (CARMA) Center, University of Utah School of Medicine, Salt Lake City, Utah, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Atrial Fibrillation / pathology*,  surgery
Catheter Ablation*
Contrast Media
Disease Progression
Female
Heart Atria / pathology*
Humans
Magnetic Resonance Imaging*
Male
Middle Aged
Grant Support
ID/Acronym/Agency:
P41 RR012553/RR/NCRR NIH HHS; P41 RR012553-10/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Contrast Media
Comments/Corrections
Comment In:
Heart Rhythm. 2010 Oct;7(10):1482-3   [PMID:  20637900 ]

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


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