title: Clinical value of assessment of left atrial late gadolinium enhancement in patients undergoing ablation of atrial fibrillation.
abstract: BACKGROUND
  Left atrial (LA) fibrosis begets atrial fibrillation (AF). Cardiovascular magnetic resonance (CMR) using the late gadolinium enhancement (LGE) technique might visualize the LA fibrosis and thus help to choose an appropriate strategy for treatment of AF. In this regard, we investigated whether the extent of preablation LA LGE would predict AF recurrence after ablation in a non-selected patient population.
  
  
  METHODS
  CMR was performed in 95 patients before radiofrequency ablation of AF. An interpretable scan was available in 73 patients (age, 59 ± 8 years; men, 71%; persistent/paroxysmal AF, 55/45%). The extent of LA LGE was quantified by three established thresholding techniques. In addition, CMR was used to quantify LA volume and reservoir function. The patients were followed for AF recurrence for 1.3 ± 0.8 years.
  
  
  RESULTS
  The arrhythmia recurred in 29 (40%) of the patients. The extent of LA LGE did not differ between paroxysmal and persistent AF and it did not predict the AF recurrence. Moreover, the extent of LA LGE did not correlate with LA volume, reservoir function and bipolar voltage.
  
  
  CONCLUSIONS
  Our data indicate a limited value of a routine assessment of LA LGE before ablation of AF. Further experimental and clinical researches should be done before applying the method to a wide clinical practice.
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Videnska 1958/9, 14021 Prague, Czech Republic. Electronic address: marek.sramko@ikem.cz.
authors.forename: Marek
authors.initials: M
authors.lastname: Sramko
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Videnska 1958/9, 14021 Prague, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Peichl
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Videnska 1958/9, 14021 Prague, Czech Republic.
authors.forename: Dan
authors.initials: D
authors.lastname: Wichterle
authors.affiliation: Department of Radiology, Institute for Clinical and Experimental Medicine (IKEM), Videnska 1958/9, 14021 Prague, Czech Republic.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Tintera
authors.affiliation: Department of Radiology, Na Homolce Hospital, Roentgenova 2/37, 15030 Prague, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Weichet
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Videnska 1958/9, 14021 Prague, Czech Republic.
authors.forename: Radoslav
authors.initials: R
authors.lastname: Maxian
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Videnska 1958/9, 14021 Prague, Czech Republic.
authors.forename: Silvia
authors.initials: S
authors.lastname: Pasnisinova
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Videnska 1958/9, 14021 Prague, Czech Republic.
authors.forename: Radka
authors.initials: R
authors.lastname: Kockova
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Videnska 1958/9, 14021 Prague, Czech Republic.
authors.forename: Josef
authors.initials: J
authors.lastname: Kautzner
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium; D006325:Heart Atria / Q000473:pathology* / Q000601:surgery; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D008875:Middle Aged; D011868:Radioisotopes
chemical_list: D003287:Contrast Media; D011868:Radioisotopes; D005682:Gadolinium
keywords: Ablation; Atrial fibrillation; Fibrosis; Magnetic resonance imaging