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Incidental LV LGE on CMR Imaging in Atrial Fibrillation Predicts Recurrence After Ablation Therapy
- Source :
- JACC: Cardiovascular Imaging. 8(7):793-800
- Publication Year :
- 2015
- Publisher :
- Elsevier BV, 2015.
-
Abstract
- ObjectivesThis study sought to evaluate the prognostic significance of left ventricular late gadolinium enhancement (LV-LGE) incidentally found in atrial fibrillation (AF) patients who undergo ablation therapy.BackgroundLV-LGE provides prognostic information in patients with ischemic and nonischemic cardiomyopathies. However, data on the clinical significance of incidental LV-LGE in the AF population are limited.MethodsA total of 778 patients who were referred for radiofrequency ablation of AF underwent cardiac magnetic resonance examinations between June 2006 and January 2013. Patients with a history of myocardial infarction or ablation therapy were excluded. The presence of LV-LGE was assessed by experienced imaging physicians. Patients were followed for arrhythmia recurrence after the radiofrequency ablation procedure.ResultsOf 598 patients included in the study, 60% were men with a mean age of 64 years and a median AF duration of 25 months. LV-LGE was detected in 39 patients (6.5%). There were 240 arrhythmia recurrences observed involving 40% of patients over a median follow-up period of 52 months. On univariate analysis, age (hazard ratio [HR]: 1.02; 95% confidence interval [CI]: 1.00 to 1.03), male sex (HR: 0.63; 95% CI: 0.47 to 0.86), diabetes (HR: 1.53; 95% CI: 1.03 to 2.27), CHADS2 score (HR: 1.19; 95% CI: 1.04 to 1.36), CHA2DS2-VASc score (HR: 1.18; 95% CI: 1.08 to 1.30), left atrial (LA) fibrosis (HR: 1.66; 95% CI: 1.41 to 1.96), LV-LGE (HR: 1.83; 95% CI: 1.11 to 3.03), persistent AF (HR: 1.52; 95% CI: 1.11 to 2.09), and LA area (HR: 1.03; 95% CI: 1.01 to 1.05) were significantly associated with arrhythmia recurrence. The recurrence rate was 69% in patients with LV-LGE compared with 38% in patients without LV-LGE (p < 0.001). In a multivariate model, LA fibrosis and LV-LGE were independent predictors of arrhythmia recurrence.ConclusionsIn AF patients without history of myocardial infarction, LV-LGE is a significant independent predictor of arrhythmia recurrence after ablation therapy.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Gadolinium
chemistry.chemical_element
Catheter ablation
cardiac magnetic resonance
Recurrence
Internal medicine
medicine
Humans
Ventricular Function
Late gadolinium enhancement
atrial fibrillation
Radiology, Nuclear Medicine and imaging
cardiovascular diseases
Aged
medicine.diagnostic_test
business.industry
Atrial fibrillation
Magnetic resonance imaging
Middle Aged
Prognosis
medicine.disease
Magnetic Resonance Imaging
ablation therapy
late gadolinium enhancement
chemistry
Radiology Nuclear Medicine and imaging
Catheter Ablation
cardiovascular system
Cardiology
Ablation Therapy
Female
Radiology
Cardiac magnetic resonance
business
Cardiology and Cardiovascular Medicine
Forecasting
Subjects
Details
- ISSN :
- 1936878X
- Volume :
- 8
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- JACC: Cardiovascular Imaging
- Accession number :
- edsair.doi.dedup.....cea704ff8aa67522f196c7a82494788d
- Full Text :
- https://doi.org/10.1016/j.jcmg.2015.03.008