title: Effect of atrial fibrillation ablation on myocardial function: insights from cardiac magnetic resonance feature tracking analysis.
abstract: Restoration of sinus rhythm may result in an improvement of left heart function in patients with atrial fibrillation (AF). Cardiovascular magnetic resonance (CMR) feature tracking (FT) technique may help detect subtle wall-motion abnormalities. Consequently this study aimed to analyse existence and reversibility of subclinical cardiac dysfunction following atrial fibrillation ablation. 28 consecutive patients (mean age 61 years) with paroxysmal AF underwent pulmonary vein isolation. CMR imaging was done 3 (±3) days before and 3.4 (±1.1) months after ablation. Left heart function was determined by performing FT analysis. Statistical analysis included paired student's t test, random effects metaanalysis to assess the cohort's health status and Bland-Altman analysis. 17 patients (61%) were free from AF at follow-up. Bland-Altman analysis showed good coefficients of variation. Of all 195 parameters, 27 changed (14%): 9 improved significantly (5%), 12 worsened significantly (6%), whereas 6 parameters worsened not significantly (3%). 18 of 120 systolic parameters changed (15%), 14 worsened (12%), 4 improved (3%). In 9 of 75 diastolic parameters, values changed (12%): 5 improved (7%) and 4 worsened (5%). Meta-analysis revealed that our collective's FT values at baseline didn't differ significantly from healthy volunteers' values [Q values of 0.01 (p value 0.921) and 1.499 (p value 0.221)]. AF patients undergoing ablation appear to have near normal cardiac wall motion, which does not improve following successful ablation. Feature tracking analysis is a reliable tool to determine treatment effects but is more likely to show positive findings if the population is unhealthy.
authors.affiliation: Advanced Cardiovascular Imaging, Centre for Advanced Cardiovascular Imaging, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, The London Chest Hospital, Queen Mary University of London, Bonner Road, London, E2 9JX, UK, Felix.Ceelen@campus.lmu.de.
authors.forename: Felix
authors.initials: F
authors.lastname: Ceelen
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Hunter
authors.forename: Redha
authors.initials: R
authors.lastname: Boubertakh
authors.forename: Wieland H
authors.initials: WH
authors.lastname: Sommer
authors.forename: Marco
authors.initials: M
authors.lastname: Armbruster
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Schilling
authors.forename: Steffen E
authors.initials: SE
authors.lastname: Petersen
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D003971:Diastole; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left