A comprehensive multi‐index cardiac magnetic resonance‐guided assessment of atrial fibrillation substrate prior to ablation: Prediction of long‐term outcomes
Why the study?
Multiple CMR-derived indices of AF substrate predict ablation outcomes in isolation, but their relative contributions needed validation in a comprehensive multi-index assessment.
Does comprehensive CMR-derived assessment of atrial fibrillation substrate predict long-term AF recurrence in patients undergoing first-time AF ablation?
Comparison
Patients with vs without AF recurrence after ablation
Design
Single-center cohort study
Follow-up
Median 726 days [IQR: 418-1010 days]
Authors
Discussion
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Member takes
Implication
Only LA fibrosis independently predicted recurrence; leaves open value of multi-index CMR models for ablation risk stratification.
Structured PICO
Does comprehensive CMR-derived assessment of atrial fibrillation substrate predict long-term AF recurrence in patients undergoing first-time AF ablation?
P
Population
89 patients (53% paroxysmal AF, 73% male) undergoing first-time atrial fibrillation ablation
I
Intervention
Comprehensive cardiac magnetic resonance (CMR) assessment of atrial fibrillation substrate (including LA fibrosis, LA volume, LA sphericity, LAEF, and LVEF) prior to ablation
O
Outcome
Late atrial fibrillation recurrencehard clinical
LA fibrosis assessed by CMR prior to first-time AF ablation is an independent predictor of long-term AF recurrence, outperforming other CMR indices like LAEF and LVEF in combined multivariate analysis.
Limitations
- single-center study
Cite This Study
Chubb et al. (2019) studied this question.