Association of left atrial fibrosis detected by delayed-enhancement magnetic resonance imaging and the risk of stroke in patients with atrial fibrillation.

Objectives: This study tried to determine the association between left atrial (LA) fibrosis, detected using delayed-enhanced magnetic resonance imaging (DE-MRI), and the CHADS(2) score (point system based on individual clinical risk factors including congestive heart failure, hypertension, age, diabetes, and prior stroke) variables, specifically stroke.

Background: In patients with atrial fibrillation (AF), conventional markers for the risk of stroke base their higher predictive effect on clinical features, particularly previous stroke history, and not individual LA pathophysiological properties. We aimed to determine the association between LA fibrosis, detected using DE-MRI, and the CHADS(2) score variables, specifically stroke.

Echocardiographic left atrial reverse remodeling after catheter ablation of atrial fibrillation is predicted by preablation delayed enhancement of left atrium by magnetic resonance imaging.

Background: Atrial fibrosis is a hallmark of atrial structural remodeling (SRM) and leads to structural and functional impairment of left atrial (LA) and persistence of atrial fibrillation (AF). This study was conducted to assess LA reverse remodeling after catheter ablation of AF in mild and moderate-severe LA SRM.

Methods: Catheter ablation was performed in 68 patients (age 62 ± 14 years, 68% males) with paroxysmal (n = 26) and persistent (n = 42) AF.

Evaluation of the left atrial substrate in patients with lone atrial fibrillation using delayed-enhanced MRI: implications for disease progression and response to catheter ablation.

Background: Lone atrial fibrillation (AF) is thought to be a benign type or an early stage of the disease.

Objective: This study sought to compare the left atrium (LA) substrate using delayed-enhanced magnetic resonance imaging (DE-MRI) in patients with lone AF versus those with comorbidities.

Methods: Forty of 333 included patients met criteria for lone AF.

Evaluation of left atrial lesions after initial and repeat atrial fibrillation ablation: lessons learned from delayed-enhancement MRI in repeat ablation procedures.

Background: We evaluated scar lesions after initial and repeat catheter ablation of atrial fibrillation (AF) and correlated these regions to low-voltage tissue on repeat electroanatomic mapping. We also identified gaps in lesion sets that could be targeted and closed during repeat procedures.

Methods And Results: One hundred forty-four patients underwent AF ablation and received a delayed-enhancement MRI at 3 months after ablation.

Left atrial strain and strain rate in patients with paroxysmal and persistent atrial fibrillation: relationship to left atrial structural remodeling detected by delayed-enhancement MRI.

Background: Atrial fibrillation (AF) is a progressive condition that begins with hemodynamic and/or structural changes in the left atrium (LA) and evolves through paroxysmal and persistent stages. Because of limitations with current noninvasive imaging techniques, the relationship between LA structure and function is not well understood.

Methods And Results: Sixty-five patients (age, 61.

Initial experience of assessing esophageal tissue injury and recovery using delayed-enhancement MRI after atrial fibrillation ablation.

Background: Esophageal wall thermal injury after atrial fibrillation ablation is a potentially serious complication. However, no noninvasive modality has been used to describe and screen patients to examine whether esophageal wall injury has occurred. We describe a noninvasive method of using delayed-enhancement MRI to detect esophageal wall injury and subsequent recovery after atrial fibrillation ablation.

Magnetic resonance imaging-confirmed ablative debulking of the left atrial posterior wall and septum for treatment of persistent atrial fibrillation: rationale and initial experience.

Introduction: Though pulmonary vein (PV) isolation has been widely adopted for treatment of atrial fibrillation (AF), recurrence rates remain unacceptably high with persistent and longstanding AF. As evidence emerges for non-PV substrate changes in the pathogenesis of AF, more extensive ablation strategies need further study.

Methods: We modified our PV antrum isolation procedure to include abatement of posterior and septal wall potentials.

MRI in cardiac electrophysiology: the emerging role of delayed-enhancement MRI in atrial fibrillation ablation.

Catheter ablation of atrial fibrillation has emerged as a viable therapeutic option for those patients who have failed conventional medical therapy. This treatment strategy has been introduced in the past decade following the discovery of ectopic foci in the pulmonary veins capable of initiating this arrhythmia. The basis of current ablation techniques relies on inducing myocardial necrosis at distinct anatomical landmarks in order to electrically isolate these ectopic foci and to disrupt pulmonary vein and left atrial conduction pathways.

Detection and quantification of left atrial structural remodeling with delayed-enhancement magnetic resonance imaging in patients with atrial fibrillation.

Background: Atrial fibrillation (AF) is associated with diffuse left atrial fibrosis and a reduction in endocardial voltage. These changes are indicators of AF severity and appear to be predictors of treatment outcome. In this study, we report the utility of delayed-enhancement magnetic resonance imaging (DE-MRI) in detecting abnormal atrial tissue before radiofrequency ablation and in predicting procedural outcome.

Temporal left atrial lesion formation after ablation of atrial fibrillation.

Background: Atrial fibrillation (AF) ablation uses radiofrequency (RF) energy to induce thermal damage to the left atrium (LA) in an attempt to isolate AF circuits. This injury can be seen using delayed enhancement magnetic resonance imaging (DE-MRI).

Objective: The purpose of this study was to describe DE-MRI findings of the LA in the acute and chronic stages postablation.

New magnetic resonance imaging-based method for defining the extent of left atrial wall injury after the ablation of atrial fibrillation.

Objectives: We describe a noninvasive method of detecting and quantifying left atrial (LA) wall injury after pulmonary vein antrum isolation (PVAI) in patients with atrial fibrillation (AF). Using a 3-dimensional (3D) delayed-enhancement magnetic resonance imaging (MRI) sequence and novel processing methods, LA wall scarring is visualized at high resolution after radiofrequency ablation (RFA).

Background: Radiofrequency ablation to achieve PVAI is a promising approach to curing AF.