Evaluation of Pulmonary Vein Fibrosis Following Cryoballoon Ablation of Atrial Fibrillation: A Semi-Automatic MRI Analysis.

Autor:	Ballatore A; Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, 10126 Turin, Italy., Negrello E; SC Chirurgia Generale 2, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy., Gatti M; Radiology Unit, Department of Diagnostic Imaging and Interventional Radiology, Città della Salute e della Scienza Hospital, 10126 Turin, Italy., Matta M; Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, 10126 Turin, Italy., Desalvo P; Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, 10126 Turin, Italy., Marcialis L; Dipartimento di Ingegneria Civile e Architettura, Università di Pavia, 27100 Pavia, Italy., Marconi S; Dipartimento di Ingegneria Civile e Architettura, Università di Pavia, 27100 Pavia, Italy.; Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy., Tore D; Radiology Unit, Department of Diagnostic Imaging and Interventional Radiology, Città della Salute e della Scienza Hospital, 10126 Turin, Italy., Magnano M; Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, 10126 Turin, Italy., Bissolino A; Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, 10126 Turin, Italy., De Lio G; Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, 10126 Turin, Italy., De Ferrari GM; Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, 10126 Turin, Italy., Conti M; Dipartimento di Ingegneria Civile e Architettura, Università di Pavia, 27100 Pavia, Italy., Faletti R; Radiology Unit, Department of Diagnostic Imaging and Interventional Radiology, Città della Salute e della Scienza Hospital, 10126 Turin, Italy., Anselmino M; Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, 10126 Turin, Italy.
Jazyk:	angličtina
Zdroj:	Journal of cardiovascular development and disease [J Cardiovasc Dev Dis] 2023 Sep 14; Vol. 10 (9). Date of Electronic Publication: 2023 Sep 14.
DOI:	10.3390/jcdd10090396
Abstrakt:	Current guidelines recommend the use of cardiac magnetic resonance imaging (MRI) for the management of atrial fibrillation (AF). However, the widespread use of cardiac MRI in clinical practice is difficult to achieve. The aim of the present study is to assess whether cardiac MRI can be adopted to identify ablation-induced fibrosis, and its relationship with AF recurrences. Fifty patients undergoing AF cryoballoon ablation were prospectively enrolled. Cardiac MRI was performed before and 30 days after the index ablation. Commercially available software and a specifically designed image processing workflow were used to quantify left atrium (LA) fibroses. Thirty-six patients were finally included in the analysis; twenty-eight were analyzed with the dedicated workflow. Acute electrical isolation was achieved in 98% of the treated pulmonary veins (PVs). After a median follow-up of 16 months, AF recurrences occurred in 12 patients (33%). In both analyses, no differences were found between the subgroups of patients with and without recurrence in the variation of either LA fibrosis or fibrosis at the ostium of the PV, before and after ablation. The ability to predict arrhythmic recurrences evaluated via the ROC curve of the variations in both LA fibrosis (AUC 0.566) and PV fibrosis (AUC 0.600) was low. Cardiac MRI holds the potential to provide clinically significant information on LA disease and AF progression; however, LA fibrosis cannot be easily identified, either by currently available commercial programs or custom tools.
Databáze:	MEDLINE
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