Cardiac Sympathetic Activity and Rhythm Control Following Pulmonary Vein Isolation in Patients with Paroxysmal Atrial Fibrillation—A Prospective 123I-mIBG-SPECT/CT Imaging Study

Figures

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  Figure 1. Global cardiac sympathetic innervation determined by late H/M ratios (A) and global washout rate (B). Late H/M ratios and washout rate (in %) are shown before and after PVI.

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  Figure 2. Summed defect score (SDS) in individual patients. (A) SDS is shown before and after PVI. * p < 0.05. (B,C) I-123-mIBG scan in a patient before and after PVI displaying a novel innervation deficit (white arrows) after PVI. (B) Polar map and (C) short axis slices of the left ventricle.

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  Figure 3. Quantitative 17-segmental analysis of the late I-123-mIBG uptake (left) and washout (right) of the left ventricle after PVI. Values are expressed as mean regional uptake in comparison to the regional maximum uptake and segmental washout (%). Significantly reduced uptake is highlighted in red (mean values after PVI compared to mean values before PVI).

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  Figure 4. Quantitative 17-segmental analysis of the late I-123-mIBG uptake (left) and washout (right) of the left ventricle after PVI in patients with AF relapse (A) and in patients without AF relapse (B). Values are expressed as mean regional uptake in comparison to the regional maximum uptake and segmental washout (%). Significantly reduced uptake and reduced regional washout is highlighted in red; significantly elevated tracer uptake and elevated washout is highlighted in green (mean values after therapy compared to mean values before PVI).

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  Figure 5. Analysis of the subgroup of patients treated with antiarrhythmic drug therapy only (“AAT”, n = 3). Global cardiac sympathetic innervation determined by late H/M ratios (A) and global washout rate (B). Late H/M ratios and washout rate (in %) are shown before and after initiation of drug therapy. (C) Summed defect score (SDS) in individual patients. SDS is shown before and after initiation of drug therapy.