Aim of this study was to evaluate the relationship between regions of interest (ROIs) from CARTOFINDER (CF) mapping and atrial cardiomyopathy from late gadolinium enhancement (LGE) cardiovascular magnetic resonance imaging (CMR).
Twenty consecutive patients underwent index catheter ablation for persistent AF (PERS AF). Pre-processed LGE CMR images were merged with the results from CF mapping to visualize harboring regions for focal and rotational activities. Atrial cardiomyopathy was classified based on the four Utah stages.
Procedural success was achieved in all patients (n = 20, 100%). LGE CMR revealed an intermediate amount of 21.41% ± 6.32% for LA fibrosis. ROIs were identified in all patients (mean no ROIs per patient n = 416.45 ± 204.57). A tendency towards a positive correlation between the total amount of atrial cardiomyopathy and the total number of ROIs per patient (regression coefficient, β = 10.86, p = .15) was observed. The degree of fibrosis and the presence of ROIs per segment showed no consistent spatial correlation (posterior: β = 0.36, p-value (p) = .24; anterior: β = -0.08, p = .54; lateral: β = 0.31, p = 39; septal: β = -0.12; p = .66; right PVs: β = 0.34, p = .27; left PVs: β = 0.07, p = .79; LAA: β = -0.91, p = .12). 12 months AF-free survival was 70% (n = 14) after ablation.
The presence of ROIs from CF mapping was not directly associated with the extent and location of fibrosis. Further studies evaluating the relationship between focal and rotational activity and atrial cardiomyopathy are mandatory.
目的:本研究的目的是评估来自CARTOFINDER(CF)标测的感兴趣区域(ROI)与晚期钆增强(LGE)心血管磁共振成像(CMR)的心房心肌病之间的关系。
方法:20例连续患者接受永久性房颤(PERSAF)的指征导管消融术。预处理的LGECMR图像与CF映射的结果合并,以可视化病灶和旋转活动的窝藏区域。心房心肌病根据犹他州的四个阶段进行分类。
结果:所有患者均获得了手术成功(n=20,100%)。LGECMR显示LA纤维化的中间量为21.41%±6.32%。在所有患者中都确定了ROI(平均每位患者n=416.45±204.57)。心房心肌病的总量与每位患者的ROI总数之间呈正相关的趋势(回归系数,观察到β=10.86,p=.15)。纤维化程度和每段ROIs的存在没有一致的空间相关性(后:β=0.36,p值(p)=.24;前:β=-0.08,p=.54;外侧:β=0.31,p=39;间隔:β=-0.12;p=.66;右PVs:β=0.34,p=.27;左PVs:β=0.07,p=0.AA=.91;消融术后12个月无房颤生存率为70%(n=14)。
结论:来自CF作图的ROI的存在与纤维化的程度和位置没有直接关系。必须进一步研究评估局灶性和旋转活动与心房心肌病之间的关系。