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Atrial Fibrosis by Late Gadolinium Enhancement Magnetic Resonance Imaging and Catheter Ablation of Atrial Fibrillation: 5‐Year Follow‐Up Data
- Source :
- Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Background Late gadolinium enhancement magnetic resonance imaging is an effective tool for assessment of atrial fibrosis. The degree of left atrial fibrosis is a good predictor of atrial fibrillation ( AF ) ablation success at 1 year, but the association between left atrial fibrosis and long‐term ablation success has not been studied. Methods and Results Late gadolinium enhancement magnetic resonance images of sufficient quality to quantify atrial fibrosis were obtained before the first AF ablation in 308 consecutive patients. Left atrial fibrosis was classified in 4 Utah stages (I, 0–10%; II , 10–20%; III , 20–30%; and IV , >30%). Patients were followed up for up to 5 years until the time of first arrhythmia recurrence or second ablation. A total of 308 patients were included; the mean age was 64.5±12.1 years, and 63.4% were men. During follow‐up, 157 patients experienced an arrhythmia recurrence and 106 patients underwent a repeated ablation. A graded effect was observed in which patients with more advanced atrial fibrosis were more likely to experience recurrent AF (hazard ratio for stage IV versus stage I, 2.73; 95% confidence interval, 1.57–4.75) and undergo a repeated ablation (proportional odds ratio for stage IV versus stage I, 5.19; 95% confidence interval, 2.12–12.69). Conclusions The degree of left atrial fibrosis predicts the success of AF ablation at up to 5 years follow‐up. In patients with advanced atrial fibrosis, AF ablation is associated with a high procedural failure rate.
- Subjects :
- Male
medicine.medical_specialty
5 year follow up
medicine.medical_treatment
Magnetic Resonance Imaging (MRI)
Contrast Media
Gadolinium
Catheter ablation
030204 cardiovascular system & hematology
ablation
03 medical and health sciences
0302 clinical medicine
Fibrosis
Internal medicine
Atrial Fibrillation
Clinical Studies
medicine
Humans
Late gadolinium enhancement
Arrhythmia and Electrophysiology
cardiovascular diseases
Heart Atria
030212 general & internal medicine
Aged
Original Research
Quality and Outcomes
medicine.diagnostic_test
business.industry
fibrosis
Atrial fibrillation
Magnetic resonance imaging
Middle Aged
medicine.disease
Ablation
Magnetic Resonance Imaging
Treatment Outcome
Atrial fibrosis
cardiovascular system
Catheter Ablation
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 20479980
- Volume :
- 7
- Database :
- OpenAIRE
- Journal :
- Journal of the American Heart Association
- Accession number :
- edsair.doi.dedup.....0f11a328f0097d33ca78155131c3f97a
- Full Text :
- https://doi.org/10.1161/jaha.117.006313