Effect of atrial fibrillation ablation on myocardial function: insights from cardiac magnetic resonance feature tracking analysis

Abstract

Restoration of sinus rhythm may result in an improvement of left heart function in patients with atrial fibrillation (AF). Cardiovascular magnetic resonance (CMR) feature tracking (FT) technique may help detect subtle wall-motion abnormalities. Consequently this study aimed to analyse existence and reversibility of subclinical cardiac dysfunction following atrial fibrillation ablation. 28 consecutive patients (mean age 61 years) with paroxysmal AF underwent pulmonary vein isolation. CMR imaging was done 3 (±3) days before and 3.4 (±1.1) months after ablation. Left heart function was determined by performing FT analysis. Statistical analysis included paired student's t test, random effects metaanalysis to assess the cohort's health status and Bland-Altman analysis. 17 patients (61%) were free from AF at follow-up. Bland-Altman analysis showed good coefficients of variation. Of all 195 parameters, 27 changed (14%): 9 improved significantly (5%), 12 worsened significantly (6%), whereas 6 parameters worsened not significantly (3%). 18 of 120 systolic parameters changed (15%), 14 worsened (12%), 4 improved (3%). In 9 of 75 diastolic parameters, values changed (12%): 5 improved (7%) and 4 worsened (5%). Meta-analysis revealed that our collective's FT values at baseline didn't differ significantly from healthy volunteers' values [Q values of 0.01 (p value 0.921) and 1.499 (p value 0.221)]. AF patients undergoing ablation appear to have near normal cardiac wall motion, which does not improve following successful ablation. Feature tracking analysis is a reliable tool to determine treatment effects but is more likely to show positive findings if the population is unhealthy.

Cardiac magnetic resonance tissue tracking in right ventricle: Feasibility and normal values

“…However, tracking based on the boundary may be subject to errors due to the image noise and the complex anatomical structure along the boundary. In some previous studies using typical feature tracking software, manual corrections were needed for correcting inaccurate tracking results, which could potentially introduce inconsistency into the study (18).…”

Lung Deflation and Cardiovascular Structure and Function in Chronic Obstructive Pulmonary Disease. A Randomized Controlled Trial

“…Cardiac volume and function data were acquired according to local protocol and international guidance, as described previously (10). Endocardial and epicardial contours were manually segmented and summed using semiautomated software (CVI 42; Circle Cardiovascular Imaging Inc., Calgary, Canada).…”

Age- and gender-related normal left ventricular deformation assessed by cardiovascular magnetic resonance feature tracking

“…The feature tracking algorithm is a two-dimensional deformation analysis of the myocardium that was originally designed for post-processing echocardiographic imaging studies, which now has been adapted and applied to standard CMR SSFP images without the need for additional, time-consuming CMR scans or sequences like myocardial tagging, strain-encoding (SENC) or displacement-encoding (DENSE) CMR [7-9]. Furthermore, this novel approach may have potential advantages over existing methods, mainly its broad availability and applicability as well as its vendor independency.…”