Universität zu Köln

Nuehrich, Jana M., Geisler, Anne C., Steven, Daniel, Hoffmann, Boris A., Schaeffer, Benjamin, Lund, Gunnar, Stehning, Christian, Radunski, Ulf K., Sultan, Arian, Schwarzl, Michael, Adam, Gerhard, Willems, Stephan and Muellerleile, Kai (2017). Active Atrial Function and Atrial Scar Burden After Multiple Catheter Ablations of Persistent Atrial Fibrillation. PACE-Pacing Clin. Electrophysiol., 40 (2). S. 175 - 183. HOBOKEN: WILEY. ISSN 1540-8159

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Abstract

Background: Extensive and repeated substrate modification (SM) is frequently performed as an ablation strategy in persistent atrial fibrillation (persAF). The effect of these extended ablation strategies on atrial function has not been investigated sufficiently so far. The purpose was to assess atrial function by cardiac magnetic resonance (CMR) and its association with left atrial (LA) scar burden by electroanatomical voltage-mapping after multiple persAF ablation procedures. Methods: We included 16 persAF patients who had >= 2 SM procedures and a control group (CG) of 21 persAF patients without prior ablation. CMR was performed in sinus rhythm at least 4 weeks after the last cardioversion. Active left and right (RA) atrial emptying fractions (AEF) as well as peak active left atrial appendage (LAA) emptying velocities were obtained by CMR flow measurements. Furthermore, LA scar burden was quantified on electroanatomical voltage maps by the portion of points with local voltage amplitude < 0.2 mV. Results: We found median LA-AEF to be lower (13 [9-22] vs 32 [26-36] %, P < 0.001) and median LA scar burden to be higher (40 [20-68] vs nine [3-18] %, P < 0.05) in the SM group compared with the CG. Furthermore, a significant correlation was found between mean LA voltage and LA-AEF (r(2) = 0.62, P < 0.001). No significant differences were detected with respect to median RA-AEF (41 [ 28-48] vs 47 [35-50] %, P = 0.43) and median peak LAA emptying velocities (30 [16-40] vs 17 [13-28] cm/s, P = 0.07). Conclusions: Active LA function is preserved but significantly impaired and associated with ablationrelated LA scar burden after multiple extensive persAF ablations.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Nuehrich, Jana M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Geisler, Anne C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Steven, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoffmann, Boris A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaeffer, Benjamin UNSPECIFIED UNSPECIFIED UNSPECIFIED Lund, Gunnar UNSPECIFIED UNSPECIFIED UNSPECIFIED Stehning, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Radunski, Ulf K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sultan, Arian UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwarzl, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Adam, Gerhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Willems, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Muellerleile, Kai UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-240587
DOI:	10.1111/pace.13004
Journal or Publication Title:	PACE-Pacing Clin. Electrophysiol.
Volume:	40
Number:	2
Page Range:	S. 175 - 183
Date:	2017
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1540-8159
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CARDIOVASCULAR MAGNETIC-RESONANCE; VEIN ANTRUM ISOLATION; TISSUE; VOLUME; ASSOCIATION; SIZE; MRI Multiple languages Cardiac & Cardiovascular Systems; Engineering, Biomedical Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24058