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Published in: Journal of Interventional Cardiac Electrophysiology 3/2015

01-12-2015

Poor scar formation after ablation is associated with atrial fibrillation recurrence

Authors: Bhrigu R. Parmar, Tyler R. Jarrett, Eugene G. Kholmovski, Nan Hu, Dennis Parker, Rob S. MacLeod, Nassir F. Marrouche, Ravi Ranjan

Published in: Journal of Interventional Cardiac Electrophysiology | Issue 3/2015

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Abstract

Purpose

Patients routinely undergo ablation for atrial fibrillation (AF) but the recurrence rate remains high. We explored in this study whether poor scar formation as seen on late-gadolinium enhancement magnetic resonance imaging (LGE-MRI) correlates with AF recurrence following ablation.

Methods

We retrospectively identified 94 consecutive patients who underwent their initial ablation for AF at our institution and had pre-procedural magnetic resonance angiography (MRA) merged with left atrial (LA) anatomy in an electroanatomic mapping (EAM) system, ablated areas marked intraprocedurally in EAM, 3-month post-ablation LGE-MRI for assessment of scar, and minimum of 3-months of clinical follow-up. Ablated area was quantified retrospectively in EAM and scarred area was quantified in the 3-month post-ablation LGE-MRI.

Results

With the mean follow-up of 336 days, 26 out of 94 patients had AF recurrence. Age, hypertension, and heart failure were not associated with AF recurrence, but LA size and difference between EAM ablated area and LGE-MRI scar area was associated with higher AF recurrence. For each percent higher difference between EAM ablated area and LGE-MRI scar area, there was a 7–9 % higher AF recurrence (p values 0.001–0.003) depending on the multivariate analysis.

Conclusions

In AF ablation, poor scar formation as seen on LGE-MRI was associated with AF recurrence. Improved mapping and ablation techniques are necessary to achieve the desired LA scar and reduce AF recurrence.
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Metadata
Title
Poor scar formation after ablation is associated with atrial fibrillation recurrence
Authors
Bhrigu R. Parmar
Tyler R. Jarrett
Eugene G. Kholmovski
Nan Hu
Dennis Parker
Rob S. MacLeod
Nassir F. Marrouche
Ravi Ranjan
Publication date
01-12-2015
Publisher
Springer US
Published in
Journal of Interventional Cardiac Electrophysiology / Issue 3/2015
Print ISSN: 1383-875X
Electronic ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-015-0060-y

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