Abstract 18310: Long Term Atrial Fibrillation Success is Predicted by the Degree of Pre-Ablation Left Atrial Fibrosis
Introduction: Late gadolinium enhancement magnetic resonance imaging (LGE-MRI) is an effective tool for quantification of atrial fibrosis. The degree of left atrial fibrosis is a good predictor of atrial fibrillation (AF) ablation success at 1 year but has not been studied for long term.
Methods: LGE-MRIs of sufficient quality to quantify atrial fibrosis were obtained prior the first AF ablation in 208 consecutive patients. Left atrial fibrosis was classified in 4 Utah stages (I: 0-10%; II: 10-20%; III: 20-30%; IV: >30%). Patients were followed for a median of 4.8 years.
Results: The mean age was 63.0 ±12.2 years. Fifty four percent of patients had paroxysmal AF and the mean LA fibrosis score was 16.3 ±11.2%. Patients with more advanced atrial fibrosis were more likely to have multiple AF ablations (I: 1.29, II: 1.32, III: 1.47, IV: 1.8, P=0.003). There was a significant difference in arrhythmia recurrences among Utah stages (I: 28% II: 37%: III: 58% IV: 91%, P<0.001) (Figure 1).
Conclusions: The degree of LA fibrosis predicts the success of AF ablation at 4.8 years follow up. The success of AF ablation is low with advanced LA fibrosis despite multiple AF ablations.
Author Disclosures: M.G. Chelu: Research Grant; Modest; Amiigo. Research Grant; Significant; Biotronik. P. Gal: None. G. Kaur: None. K.A. Johnson: None. P. Suksaranjit: None. C. Pacchia: None. N.F. Marrouche: Speakers Bureau; Modest; Medtronic. Honoraria; Modest; Biosense Webster, Boston Scientific. Ownership Interest; Modest; St Jude. Ownership Interest; Significant; Marrek, Cardiac Designs, Preventice.
- © 2016 by American Heart Association, Inc.