title: Cardiovascular magnetic resonance demonstrates reversible atrial dysfunction after catheter ablation of persistent atrial fibrillation.
abstract: BACKGROUND
  There is a paucity of data on atrial injury following ablation of persistent atrial fibrillation (AF). This study aimed at assessing reversibility of atrial dysfunction after successful persistent AF ablation using cardiovascular magnetic resonance (CMR).
  
  
  RESULTS
  CMR was performed during sinus rhythm (SR) in 20 consecutive patients with persistent AF at baseline (BL) within 24 hours after ablation and after 6-month follow-up (FU). Catheter ablation included atrial substrate modification using the stepwise approach following pulmonary vein isolation (PVI) in order to attempt termination of persistent AF. Active left (LA) and right atrial (RA) function were quantified by calculating the active emptying fraction (AEF) from transvalvular flow profiles using velocity encoded (VENC) CMR. LA appendage (LAA) function was quantified by measurements of peak a-wave velocities from flow profiles perpendicular to the LAA orifice. Peri-atrial edema was assessed using black-blood T2 -weighted CMR. A significant improvement was found in LA-AEF from 18 (12-26)% at BL to 25 (22-35)% at FU (P = 0.0001). Furthermore, RA-AEF significantly increased from 31 (19-35)% at BL to 40 (35-51)% at FU (P < 0.0001). A significant improvement was also found for LAA a-wave velocities from 45 (31-65) cm/s at BL to 62 (49-75) cm/s at FU (P < 0.01). The area of peri-atrial edema on T2 -weighted CMR decreased from 1393 (1098-1797) mm(2) at BL to 24 (1-92) mm(2) at FU (P < 0.0001).
  
  
  CONCLUSIONS
  CMR demonstrates reversibility of LA, LAA, and RA dysfunction associated with resorption of peri-atrial edema in patients with SR after persistent AF ablation.
authors.affiliation: Department of Cardiology and Electrophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. ka.muellerleile@uke.de
authors.forename: Kai
authors.initials: K
authors.lastname: Muellerleile
authors.forename: Michael
authors.initials: M
authors.lastname: Groth
authors.forename: Daniel
authors.initials: D
authors.lastname: Steven
authors.forename: Boris A
authors.initials: BA
authors.lastname: Hoffmann
authors.forename: Dennis
authors.initials: D
authors.lastname: Saring
authors.forename: Ulf K
authors.initials: UK
authors.lastname: Radunski
authors.forename: Gunnar K
authors.initials: GK
authors.lastname: Lund
authors.forename: Gerhard
authors.initials: G
authors.lastname: Adam
authors.forename: Thomas
authors.initials: T
authors.lastname: Rostock
authors.forename: Stephan
authors.initials: S
authors.lastname: Willems
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D057791:Cardiac Imaging Techniques / Q000379:methods; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged
keywords: atrial fibrillation; atrial function; atrial remodeling catheter ablation; magnetic resonance imaging