Key result
LGE MRI predicts electrical pulmonary vein reconnection with ~99% sensitivity.
Why the study?
Invasive repeat procedures are increasingly performed only to rule out PV reconnection in patients with recurrent AF after PVI, so the authors aimed to define the ability of LGE-MRI to rule out PV reconnection non-invasively.
Does LGE-MRI accurately predict or rule out pulmonary vein reconnection in patients who underwent prior pulmonary vein isolation?
Population
152 patients (304 PV pairs) undergoing an invasive repeat procedure after initial PVI and post-ablation LGE-MRI
Comparison
LGE-MRI vs invasive repeat procedure reference standard
Design
Prospective registry-based diagnostic validation study
Authors
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May aid noninvasive exclusion of PV reconnection post-PVI; leaves open whether it safely avoids repeat procedures without prospective trials.
Cohort (n=152)
Does LGE-MRI accurately predict or rule out pulmonary vein reconnection in patients who underwent prior pulmonary vein isolation?
LGE-MRI can non-invasively rule out pulmonary vein reconnection with high negative predictive value, potentially avoiding unnecessary invasive repeat procedures in patients with recurrent atrial fibrillation.
Padilla-Cueto et al. (2022) conducted a cohort in Atrial fibrillation (n=152). Late gadolinium enhancement magnetic resonance imaging (LGE-MRI) vs. Invasive repeat procedure was evaluated on Electrical pulmonary vein reconnection. Late gadolinium enhancement MRI predicted electrical pulmonary vein reconnection with 98.9% sensitivity and 55.6% specificity, and complete LGE lesion sets ruled out reconnection with a 94.4% NPV.
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