Lack of regional association between atrial late gadolinium enhancement on cardiac magnetic resonance and atrial fibrillation rotors

Jonathan Chrispin, Esra Gucuk Ipek, Sohail Zahid, Adityo Prakosa, Mohammadali Habibi, David Spragg, Joseph E. Marine, Hiroshi Ashikaga, John Rickard, Natalia A. Trayanova, Stefan L. Zimmerman, Vadim Zipunnikov, Ronald D. Berger, Hugh Calkins, Saman Nazarian

Research output: Contribution to journalArticlepeer-review

Abstract

Background The extent of left atrial (LA) late gadolinium enhancement (LGE), as a surrogate for fibrosis, has been associated with atrial fibrillation (AF) recurrence after catheter ablation. Furthermore, there is ex vivo evidence that islands of fibrosis may anchor fibrillatory rotors. Objective The purpose of this study was to examine the anatomical association of AF rotors with LA and right atrial (RA) LGE on cardiac magnetic resonance. Methods The cohort included 9 patients with persistent AF (mean age 61.1 ± 9.7 years) who underwent LGE cardiac magnetic resonance before AF ablation using the focal impulse and rotor modulation system. The extent of LA and RA LGE was quantified globally and in each of the 7 sectors: LA posterior/inferior wall, anterior wall, roof, left and right pulmonary vein antra, and RA lateral and septal regions. The multivariable association of rotor incidence with global and per sector LGE extent was examined using multivariable Bernoulli logistic regression estimated by generalized estimating equations. Results The mean RA and LA volumes were 113.2 ± 37.31 and 143.03 ± 58.25 mL, respectively. The mean RA and LA LGE burden was 17.2% ± 11.0% and 17.4% ± 14.4%, respectively. A total of 18 LA rotors and 9 RA rotors were identified in all patients. No univariable or multivariable association was observed between global or per sector LGE extent and focal impulse and rotor modulation rotor incidence. Conclusion In this cohort of patients, there was no association between AF rotor incidence and the global or regional extent of RA and LA LGE.

Original languageEnglish (US)
Pages (from-to)654-660
Number of pages7
JournalHeart Rhythm
Volume13
Issue number3
DOIs
StatePublished - Mar 1 2016

Keywords

  • Atrial fibrillation
  • Delayed enhancement magnetic resonance imaging
  • Fibrosis
  • Rotor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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