Quantification of right atrial fibrosis by cardiac magnetic resonance: verification of the method to standardize thresholds

Gunturiz‐Beltrán, Clara; Borràs, Roger; Alarcón, Francisco; Garre, Paz; Ventura, R.; Benito, Eva Maria; Caixal, Gala; Althoff, Till; Tolosana, José Marı́a; Arbelo, Elena; Roca, Ivo; Prat‐González, Susanna; Perea, Rosario J.; Brugada, Josép; Sitges, Marta; Guasch, Eduard; Mont, Lluís

doi:10.1016/j.rec.2022.06.010

Cited by 2 publications

(1 citation statement)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For the semiautomatic 3D reconstruction of LA and right atrial (RA), the atrial wall was manually traced on each axial plane slice and automatically adjusted to create a 3D shell. Late gadolinium enhancement was quantified based on voxel signal intensities relative to the mean blood pool signal intensity, using a previously validated signal intensity ratio threshold of ≥1.2 to define LGE indicative of fibrotic tissue 9 , 10 ( Figure 2 ). The 3D reconstructions were colour coded accordingly after the exclusion of extra-cardiac structures, such as pulmonary veins (PV), LA and RA appendages.…”

Section: Methodsmentioning

confidence: 99%

Magnetic resonance detection of advanced atrial cardiomyopathy increases the risk for atypical atrial flutter occurrence following atrial fibrillation ablation

Ferró,

Pérez,

Althoff

et al. 2023

Europace

View full text Add to dashboard Cite

Aims Recurrence of arrhythmia after catheter ablation of atrial fibrillation (AF) in the form of atypical atrial flutter (AFL) is common among a significant number of patients and often requires redo ablation with limited success rates. Identifying patients at high risk of AFL after AF ablation could aid in patient selection and personalized ablation approach. The study aims to assess the relationship between pre-existing atrial cardiomyopathy and the occurrence of AFL following AF ablation. Methods and results We analysed a cohort of 1007 consecutive AF patients who underwent catheter ablation and were included in a prospective registry. Patients who did not have baseline cardiac magnetic resonance imaging and late gadolinium enhancement (LGE-CMR) or did not experience any recurrences were excluded. A total of 166 patients were included gathering 56 patients who underwent re-ablation due to AFL recurrences and 110 patients who underwent re-ablation due to AF recurrences (P = 0.11). A multiparametric assessment of atrial cardiomyopathy was based on basal LGE-CMR, including left atrial (LA) volume, LA sphericity, and global and segmental LA fibrosis using semiautomated post-processing software. Out of the initial cohort of 1007 patients, AFL and AF occurred in 56 and 110 patients, respectively. An age higher than 65 [odds ratio (OR) = 5.6, 95% confidence interval (CI): 2.2–14.4], the number of previous ablations (OR = 3.0, 95% CI: 1.2–7.8), and the management of ablation lines in the index procedure (OR = 2.5, 95% CI: 1.0–6.3) were independently associated with AFL occurrence. Furthermore, several characteristics assessed by LGE-CMR were identified as independent predictors of AFL recurrence after the index ablation for AF, such as enhanced LA sphericity (OR = 1.3, 95% CI: 1.1–1.6), LA global fibrosis (OR = 1.03, 95% CI: 1.01–1.07), and increased fibrosis in the lateral wall (OR = 1.03, 95% CI: 1.01–1.04). Conclusion Advanced atrial cardiomyopathy assessed by LGE-CMR, such as increased LA sphericity, global LA fibrosis, and fibrosis in the lateral wall, is independently associated with arrhythmia recurrence in the form of AFL following AF ablation.

show abstract

Section: Methodsmentioning

confidence: 99%