PMID- 23685170
OWN - NLM
STAT- MEDLINE
DCOM- 20140410
LR  - 20220408
IS  - 1556-3871 (Electronic)
IS  - 1547-5271 (Print)
IS  - 1547-5271 (Linking)
VI  - 10
IP  - 8
DP  - 2013 Aug
TI  - Automated analysis of atrial late gadolinium enhancement imaging that correlates 
      with endocardial voltage and clinical outcomes: a 2-center study.
PG  - 1184-91
LID - S1547-5271(13)00508-0 [pii]
LID - 10.1016/j.hrthm.2013.04.030 [doi]
AB  - BACKGROUND: For late gadolinium enhancement (LGE) cardiovascular magnetic 
      resonance (CMR) assessment of atrial scar to guide management and targeting of 
      ablation in atrial fibrillation (AF), an objective, reproducible method of 
      identifying atrial scar is required. OBJECTIVE: To describe an automated method 
      for operator-independent quantification of LGE that correlates with colocated 
      endocardial voltage and clinical outcomes. METHODS: LGE CMR imaging was performed 
      at 2 centers, before and 3 months after pulmonary vein isolation for paroxysmal 
      AF (n = 50). A left atrial (LA) surface scar map was constructed by using 
      automated software, expressing intensity as multiples of standard deviation (SD) 
      above blood pool mean. Twenty-one patients underwent endocardial voltage mapping 
      at the time of pulmonary vein isolation (11 were redo procedures). Scar maps and 
      voltage maps were spatially registered to the same magnetic resonance angiography 
      (MRA) segmentation. RESULTS: The LGE levels of 3, 4, and 5SDs above blood pool 
      mean were associated with progressively lower bipolar voltages compared to the 
      preceding enhancement level (0.85 +/- 0.33, 0.50 +/- 0.22, and 0.38 +/- 0.28 mV; P = 
      .002, P < .001, and P = .048, respectively). The proportion of atrial surface 
      area classified as scar (ie, >3 SD above blood pool mean) on preablation scans 
      was greater in patients with postablation AF recurrence than those without 
      recurrence (6.6% +/- 6.7% vs 3.5% +/- 3.0%, P = .032). The LA volume >102 mL was 
      associated with a significantly greater proportion of LA scar (6.4% +/- 5.9% vs 
      3.4% +/- 2.2%; P = .007). CONCLUSIONS: LA scar quantified automatically by a simple 
      objective method correlates with colocated endocardial voltage. Greater 
      preablation scar is associated with LA dilatation and AF recurrence.
CI  - Copyright (c) 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights 
      reserved.
FAU - Malcolme-Lawes, L C
AU  - Malcolme-Lawes LC
AD  - Imperial College London and Imperial College Healthcare NHS Trust, London, United 
      Kingdom.
FAU - Juli, C
AU  - Juli C
FAU - Karim, R
AU  - Karim R
FAU - Bai, W
AU  - Bai W
FAU - Quest, R
AU  - Quest R
FAU - Lim, P B
AU  - Lim PB
FAU - Jamil-Copley, S
AU  - Jamil-Copley S
FAU - Kojodjojo, P
AU  - Kojodjojo P
FAU - Ariff, B
AU  - Ariff B
FAU - Davies, D W
AU  - Davies DW
FAU - Rueckert, D
AU  - Rueckert D
FAU - Francis, D P
AU  - Francis DP
FAU - Hunter, R
AU  - Hunter R
FAU - Jones, D
AU  - Jones D
FAU - Boubertakh, R
AU  - Boubertakh R
FAU - Petersen, S E
AU  - Petersen SE
FAU - Schilling, R
AU  - Schilling R
FAU - Kanagaratnam, P
AU  - Kanagaratnam P
FAU - Peters, N S
AU  - Peters NS
LA  - eng
GR  - PG/10/37/28347/British Heart Foundation/United Kingdom
GR  - RG/10/11/28457/British Heart Foundation/United Kingdom
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20130516
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
RN  - 0 (Contrast Media)
RN  - 0 (Organometallic Compounds)
RN  - 15G12L5X8K (gadobenic acid)
RN  - 6HG8UB2MUY (Meglumine)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Atrial Fibrillation/*pathology/surgery
MH  - Catheter Ablation/*methods
MH  - Cicatrix/*diagnosis
MH  - *Contrast Media
MH  - Female
MH  - *Gadolinium
MH  - Heart Atria/*pathology/surgery
MH  - Humans
MH  - Image Enhancement
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Meglumine/*analogs & derivatives
MH  - Middle Aged
MH  - *Organometallic Compounds
MH  - Treatment Outcome
PMC - PMC3734347
OTO - NOTNLM
OT  - 2-dimensional
OT  - 2D
OT  - AF
OT  - Atrial fibrillation
OT  - CMR
OT  - Delayed-enhancement magnetic resonance imaging
OT  - ECG
OT  - LA
OT  - LGE
OT  - MRA
OT  - Magnetic resonance angiography
OT  - PAF
OT  - RF
OT  - Radiofrequency ablation
OT  - SD
OT  - atrial fibrillation
OT  - cardiovascular magnetic resonance
OT  - electrocardiogram
OT  - late gadolinium enhancement
OT  - left atrial/atrium
OT  - paroxysmal atrial fibrillation
OT  - radiofrequency
OT  - standard deviation
EDAT- 2013/05/21 06:00
MHDA- 2014/04/11 06:00
PMCR- 2013/08/01
CRDT- 2013/05/21 06:00
PHST- 2013/01/10 00:00 [received]
PHST- 2013/05/21 06:00 [entrez]
PHST- 2013/05/21 06:00 [pubmed]
PHST- 2014/04/11 06:00 [medline]
PHST- 2013/08/01 00:00 [pmc-release]
AID - S1547-5271(13)00508-0 [pii]
AID - 10.1016/j.hrthm.2013.04.030 [doi]
PST - ppublish
SO  - Heart Rhythm. 2013 Aug;10(8):1184-91. doi: 10.1016/j.hrthm.2013.04.030. Epub 2013 
      May 16.