Left atrial volume affects the correlation of voltage map with magnetic resonance imaging.

Atrial fibrillation Atrial fibrosis Electroanatomic map LGE Left atrial volume MRI

Journal

Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
ISSN: 1572-8595
Titre abrégé: J Interv Card Electrophysiol
Pays: Netherlands
ID NLM: 9708966

Informations de publication

Date de publication:
27 Mar 2023
Historique:
received: 10 01 2023
accepted: 02 03 2023
entrez: 27 3 2023
pubmed: 28 3 2023
medline: 28 3 2023
Statut: aheadofprint

Résumé

The low-voltage area detected by electroanatomic mapping (EAM) is a surrogate marker of left atrial fibrosis. However, the correlation between the EAM and late gadolinium enhancement magnetic resonance imaging (LGE-MRI) has been inconsistent among studies. This study aimed to investigate how LA size affects the correlation between EAM and LGE-MRI. High-density EAMs of the LA during sinus rhythm were collected in 22 patients undergoing AF ablation. The EAMs were co-registered with pre-ablation LGE-MRI models. Voltages in the areas with and without LGE were recorded. Left atrial volume index (LAVI) was calculated from MRI, and LAVI > 62 ml/m Atrial bipolar voltage negatively correlates with the left atrial volume index. The median voltages in areas without LGE were 1.1 mV vs 2.0 mV in patients with vs without significant LAE (p = 0.002). In areas of LGE, median voltages were 0.4 mV vs 0.8 mV in patients with vs without significant LAE (p = 0.02). A voltage threshold of 1.7 mV predicted atrial LGE in patients with normal or mildly enlarged LA (sensitivity and specificity of 74% and 59%, respectively). In contrast, areas of voltage less than 0.75 mV correlated with LGE in patients with significant LA enlargement (sensitivity 68% and specificity 66%). LAVI affects left atrial bipolar voltage, and the correlation between low-voltage areas and LGE-MRI. Distinct voltage thresholds according to the LAVI value might be considered to identify atrial scar by EAM.

Sections du résumé

BACKGROUND BACKGROUND
The low-voltage area detected by electroanatomic mapping (EAM) is a surrogate marker of left atrial fibrosis. However, the correlation between the EAM and late gadolinium enhancement magnetic resonance imaging (LGE-MRI) has been inconsistent among studies. This study aimed to investigate how LA size affects the correlation between EAM and LGE-MRI.
METHODS METHODS
High-density EAMs of the LA during sinus rhythm were collected in 22 patients undergoing AF ablation. The EAMs were co-registered with pre-ablation LGE-MRI models. Voltages in the areas with and without LGE were recorded. Left atrial volume index (LAVI) was calculated from MRI, and LAVI > 62 ml/m
RESULTS RESULTS
Atrial bipolar voltage negatively correlates with the left atrial volume index. The median voltages in areas without LGE were 1.1 mV vs 2.0 mV in patients with vs without significant LAE (p = 0.002). In areas of LGE, median voltages were 0.4 mV vs 0.8 mV in patients with vs without significant LAE (p = 0.02). A voltage threshold of 1.7 mV predicted atrial LGE in patients with normal or mildly enlarged LA (sensitivity and specificity of 74% and 59%, respectively). In contrast, areas of voltage less than 0.75 mV correlated with LGE in patients with significant LA enlargement (sensitivity 68% and specificity 66%).
CONCLUSIONS CONCLUSIONS
LAVI affects left atrial bipolar voltage, and the correlation between low-voltage areas and LGE-MRI. Distinct voltage thresholds according to the LAVI value might be considered to identify atrial scar by EAM.

Identifiants

pubmed: 36973597
doi: 10.1007/s10840-023-01522-y
pii: 10.1007/s10840-023-01522-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

Dan L Li (DL)

Cardiac Electrophysiology Section, Department of Internal Medicine and Cardiology, Tulane University School of Medicine, New Orleans, LA, 70112, USA.
Tulane Research and Innovation for Arrhythmia Discoveries, New Orleans, LA, USA.

Abdel Hadi El Hajjar (AHE)

Tulane Research and Innovation for Arrhythmia Discoveries, New Orleans, LA, USA.

Tarek Ayoub (T)

Cardiac Electrophysiology Section, Department of Internal Medicine and Cardiology, Tulane University School of Medicine, New Orleans, LA, 70112, USA.
Tulane Research and Innovation for Arrhythmia Discoveries, New Orleans, LA, USA.

Yichi Zhang (Y)

Tulane Research and Innovation for Arrhythmia Discoveries, New Orleans, LA, USA.

Chao Huang (C)

Tulane Research and Innovation for Arrhythmia Discoveries, New Orleans, LA, USA.

Eugene G Kholmovski (EG)

Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA.

Mario Mekhael (M)

Tulane Research and Innovation for Arrhythmia Discoveries, New Orleans, LA, USA.

Charbel Noujaim (C)

Tulane Research and Innovation for Arrhythmia Discoveries, New Orleans, LA, USA.

Han Feng (H)

Tulane Research and Innovation for Arrhythmia Discoveries, New Orleans, LA, USA.

Chanho Lim (C)

Tulane Research and Innovation for Arrhythmia Discoveries, New Orleans, LA, USA.

Nassir F Marrouche (NF)

Cardiac Electrophysiology Section, Department of Internal Medicine and Cardiology, Tulane University School of Medicine, New Orleans, LA, 70112, USA. nmarrouche@tulane.edu.
Tulane Research and Innovation for Arrhythmia Discoveries, New Orleans, LA, USA. nmarrouche@tulane.edu.

Classifications MeSH