Elevated fibrosis burden as assessed by MRI predicts cryoballoon ablation failure.
LGE-MRI
atrial fibrillation
atrial fibrosis
cryoballoon ablation
Journal
Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Titre abrégé: J Cardiovasc Electrophysiol
Pays: United States
ID NLM: 9010756
Informations de publication
Date de publication:
02 2023
02 2023
Historique:
revised:
17
11
2022
received:
30
08
2022
accepted:
19
11
2022
pmc-release:
01
02
2024
pubmed:
27
12
2022
medline:
11
2
2023
entrez:
26
12
2022
Statut:
ppublish
Résumé
Late-gadolinium enhancement magnetic resonance (LGE-MRI) imaging is increasingly used in management of atrial fibrillation (AFib) patients. Here, we assess the usefulness of LGE-MRI-based fibrosis quantification to predict arrhythmia recurrence in patients undergoing cryoballoon ablation. Our secondary goal was to compare two widely used fibrosis quantification methods. In 102 AF patients undergoing LGE-MRI and cryoballoon ablation (mean age 62 years; 64% male; 59% paroxysmal AFib), atrial fibrosis was quantified using the pixel intensity histogram (PIH) and image intensity ratio (IIR) methods. PIH segmentations were completed by a third-party provider as part of the standard of care at our hospital; Image intensity ratio (IIR) segmentations of the same scans were carried out in our lab using a commercially available software package. Fibrosis burdens and spatial distributions for the two methods were compared. Patients were followed prospectively for recurrent arrhythmia following ablation. Average PIH fibrosis was 15.6 ± 5.8% of the left atrial (LA) volume. Depending on threshold (IIR PIH-based volumetric assessment of atrial fibrosis was modestly predictive of arrhythmia recurrence following cryoballoon ablation in this cohort. IIR-based fibrosis was not predictive of recurrence for any of the IIR
Identifiants
pubmed: 36571158
doi: 10.1111/jce.15791
pmc: PMC9911366
mid: NIHMS1860765
doi:
Substances chimiques
Contrast Media
0
Gadolinium
AU0V1LM3JT
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
302-312Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL158667
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002319
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2022 Wiley Periodicals LLC.
Références
Circ Arrhythm Electrophysiol. 2020 Nov;13(11):e008707
pubmed: 33031713
Heart. 2021 Jan;107(2):99-105
pubmed: 33097562
J Am Coll Cardiol. 2019 Jul 9;74(1):104-132
pubmed: 30703431
JAMA. 2022 Jun 21;327(23):2296-2305
pubmed: 35727277
Europace. 2017 Aug 01;19(8):1272-1279
pubmed: 27940935
Heart Rhythm. 2014 Jan;11(1):85-92
pubmed: 24096166
Cardiovasc Res. 2002 May;54(2):230-46
pubmed: 12062329
JAMA. 2019 Apr 2;321(13):1261-1274
pubmed: 30874766
Elife. 2021 May 04;10:
pubmed: 33942719
Circ Arrhythm Electrophysiol. 2014 Feb;7(1):23-30
pubmed: 24363354
Circulation. 2009 Apr 7;119(13):1758-67
pubmed: 19307477
Europace. 2022 Jul 21;24(7):1102-1111
pubmed: 35298612
J Cardiovasc Magn Reson. 2013 Dec 20;15:105
pubmed: 24359544
JAMA. 2014 Feb 5;311(5):498-506
pubmed: 24496537
J Cardiovasc Electrophysiol. 2011 Jan;22(1):16-22
pubmed: 20807271
Europace. 2018 Jan 1;20(1):e1-e160
pubmed: 29016840
J Cardiovasc Electrophysiol. 2021 Apr;32(4):916-924
pubmed: 33600025
Heart Rhythm. 2012 Dec;9(12):2003-9
pubmed: 23000671
Neurology. 2019 Jul 23;93(4):e381-e387
pubmed: 31239359
Nat Biomed Eng. 2019 Nov;3(11):870-879
pubmed: 31427780
Eur Heart J Cardiovasc Imaging. 2022 Aug 22;23(9):1182-1190
pubmed: 35947873