Key result
Cardiac MRI showed patients free from atrial fibrillation after ablation had higher acute delayed enhancement (71% vs 55%) and lower T2 signal (72% vs 85%) encirclement than those with recurrences.
Why the study?
Does the proportion of reversible versus irreversible atrial injury on cardiac MRI predict atrial fibrillation recurrence after pulmonary vein isolation in patients with paroxysmal AF?
Population
25 patients with paroxysmal atrial fibrillation undergoing wide-area circumferential ablation
Design
Cohort
Follow-up
11 months (interquartile range, 8-16 months)
Authors
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Acute post-ablation MRI metrics of reversible injury were associated with AF recurrence; hypothesis-generating for irreversible encirclement targets.
Observational (n=25)
Does the proportion of reversible versus irreversible atrial injury on cardiac MRI predict atrial fibrillation recurrence after pulmonary vein isolation in patients with paroxysmal AF?
Absolute Event Rate: 71% vs 55%
p-value: p=<0.05
Higher T2 signal (edema) and lower delayed enhancement (necrosis) on acute post-ablation MRI are associated with AF recurrence, suggesting reversible tissue injury leads to pulmonary vein reconnection.
Arujuna et al. (2012) conducted an observational in paroxysmal atrial fibrillation (n=25). Radiofrequency ablation with cardiac magnetic resonance imaging assessment vs. Atrial fibrillation recurrence (observational comparison) was evaluated on Percentage of circumferential antral encirclement composed of delayed enhancement (DE) on acute scans (p=<0.05). Cardiac MRI showed patients free from atrial fibrillation after ablation had higher acute delayed enhancement (71% vs 55%) and lower T2 signal (72% vs 85%) encirclement than those with recurrences.