Abstract 21264: Correlation Between Electrical and Structural Atrial Remodeling in Patients With Atrial Fibrillation: A Late Gadolinium Enhancement MRI Based Model
Introduction: Atrial fibrillation (AF) cycle length (CL) has been proposed as a baseline predictor for duration of AF, type of AF, and ablation success. We seek to study the relation between atrial fibrosis as assessed by Late Gadolinium Enhancement-MRI (LGE-MRI) and AF CL.
Methods: Twenty six patients who presented for AF ablation were included in the study. All patients underwent pre-ablation LGE-MRI to assess for atrial fibrosis prior to ablation (figure 1). The CL of 30 beats of AF was measured and averaged at two different time periods from the coronary sinus (CS) and the high right atrium (HRA).
Results: A total of 1560 beats in the LA and 1260 beats in the RA were analyzed. The mean CL in the CS was 171 ms (SD ± 34 ms). The mean CL in the HRA was 176 ms (SD ± 35.9 ms). DE-MRI atrial images were segmented and the amount of fibrosis was quantified. Using a 170 ms CL in the CS as a cut off, two groups with a significant difference in atrial fibrosis were identified (p = <0.05). There was significant correlation between AF CL and percentage of fibrosis as established by Spearman's rank correlation (figure 2 & 3).
Conclusions: Our preliminary results support a significant correlation between AF CL and atrial fibrosis as assessed by DE-MRI. These findings also suggest a correlation between atrial electrical and structural remodeling in patients with AF.
- © 2010 by American Heart Association, Inc.