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Journal of arrhythmia · 2022

The impact of the atrial wall thickness in normal/mild late-gadolinium enhancement areas on atrial fibrillation rotors in persistent atrial fibrillation patients.

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Nakamura Toshihiro, Kiuchi Kunihiko, Fukuzawa Koji, Takami Mitsuru, Watanabe Yoshiaki, Izawa Yu, Takemoto Makoto, Sakai Jun, Yatomi Atsusuke, Sonoda Yusuke, Takahara Hiroyuki, Nakasone Kazutaka, Yamamoto Kyoko, Suzuki Yuya, Tani Ken-Ichi, Negi Noriyuki, Kono Atsushi, Ashihara Takashi, Hirata Ken-Ichi

Аннотация

BACKGROUND: Some of atrial fibrillation (AF) drivers are found in normal/mild late-gadolinium enhancement (LGE) areas, as well as moderate ones. The atrial wall thickness (AWT) has been reported to be important as a possible AF substrate. However, the AWT and degree of LGEs as an AF substrate has not been fully validated in humans.

OBJECTIVE: The purpose of this study was to evaluate the impact of the AWT in normal/mild LGE areas on AF drivers.

METHODS: A total of 287 segments in 15 persistent AF patients were assessed. AF drivers were defined as non-passively activated areas (NPAs), where rotational activation was frequently observed, and were detected by the novel real-time phase mapping (ExTRa Mapping), mild LGE areas were defined as areas with a volume ratio of the enhancement voxel of 0% to <10%. The AWT was defined as the minimum distance from the manually determined endocardium to the epicardial border on the LGE-MRI.

RESULTS: NPAs were found in 20 (18.0%) of 131 normal/mild LGE areas where AWT was significantly thicker than that in the passively activated areas (PAs) (2.5 ± 0.3 vs. 2.2 ± 0.3 mm, p < .001). However, NPAs were found in 41 (26.3%) of 156 moderate LGE areas where AWT was thinner than that of PAs (2.1 ± 0.2 mm vs. 2.23 ± 0.3 mm, p = .02). An ROC curve analysis yielded an optimal cutoff value of 2.2 mm for predicting the presence of an NPA in normal/mild LGE areas.

CONCLUSION: The location of AF drivers in normal/mild LGE areas might be more accurately identified by evaluating AWT.

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

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