Author + information
- John P. Bois,
- James Glockner,
- Seth Sheldon,
- Darrell Newman,
- Grace Lin,
- Douglas Packer and
- Peter Brady
Identification of left atrial (LA) delayed gadolinium enhancement (DE) by MRI as marker of LA scar and a possible substrate for atrial fibrillation (AF) has been reported. We sought to confirm these findings in a cohort of patients to determine whether LA scar identified in this way is associated with AF occurrence and type of AF.
All patients underwent gadolinium enhanced MRI to determine the presence or absence of LA scar prior to ablation. Retrospective analysis of 137 patients who underwent pulmonary vein isolation ablation for atrial fibrillation at a single institution was conducted. Demographic, past medical and cardiac history as well as echocardiographic and laboratory data was collected. MRI data both before and after ablation was analyzed and reports of DE were documented. 2D late gadolinium enhancement images were acquired in axial and short axis projections, and 3D late gadolinium enhancement images were acquired in the axial plane 10–20 minutes following injection of 0.2 mM/kg gadodiamide (Omniscan®) or gadobenate dimeglumine (Multihance®).
The study included a total of 137 consecutive patients (mean age 59 years +/−9.7; 98 (72%) male). Of these AF was persistent in 56 (41%) and paroxysmal in 81 (59%) and 41 (30%) had undergone prior ablation procedure. Of the cohort only 13 (9%) had identifiable DE within the LA. Of the 13 patients 7 (54%) had persistent AF and 6 (46%) had paroxysmal AF. Of the 41 patients that had undergone previous left atrial ablation, LA DE was present in 5 (12%).
Our findings suggest that, in contrast to previous studies, the finding of DE within the LA walls is uncommon and, when present, does not correlate with type of AF and therefore is of unclear clinical significance.
Moderated Poster Contributions
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Atrial Fibrillation Ablation
Abstract Category: 4. Arrhythmias: AF/SVT
Presentation Number: 1278M-41
- 2013 American College of Cardiology Foundation