PMID- 31940244
OWN - NLM
STAT- MEDLINE
DCOM- 20200817
LR  - 20230516
IS  - 1941-3084 (Electronic)
IS  - 1941-3149 (Print)
IS  - 1941-3084 (Linking)
VI  - 13
IP  - 2
DP  - 2020 Feb
TI  - Association of Left Atrial High-Resolution Late Gadolinium Enhancement on Cardiac 
      Magnetic Resonance With Electrogram Abnormalities Beyond Voltage in Patients With 
      Atrial Fibrillation.
PG  - e007586
LID - 10.1161/CIRCEP.119.007586 [doi]
AB  - BACKGROUND: Conflicting data have been reported on the association of left atrial 
      (LA) late gadolinium enhancement (LGE) with atrial voltage in patients with 
      atrial fibrillation. The association of LGE with electrogram fractionation and 
      delay remains to be examined. We sought to examine the association between LA LGE 
      on cardiac magnetic resonance and electrogram abnormalities in patients with 
      atrial fibrillation. METHODS: High-resolution LGE cardiac magnetic resonance was 
      performed before electrogram mapping and ablation in atrial fibrillation 
      patients. Cardiac magnetic resonance features were quantified using LA myocardial 
      signal intensity Z score (SI-Z), a continuous normalized variable, as well as a 
      dichotomous LGE variable based on previously validated methodology. Electrogram 
      mapping was performed pre-ablation during sinus rhythm or LA pacing, and 
      electrogram locations were coregistered with cardiac magnetic resonance images. 
      Analyses were performed using multilevel patient-clustered mixed-effects 
      regression models. RESULTS: In the 40 patients with atrial fibrillation (age, 
      63.2+/-9.2 years; 1312.3+/-767.3 electrogram points per patient), lower bipolar 
      voltage was associated with higher SI-Z in patients who had undergone previous 
      ablation (coefficient, -0.049; P<0.001) but not in ablation-naive patients 
      (coefficient, -0.004; P=0.7). LA electrogram activation delay was associated with 
      SI-Z in patients with previous ablation (SI-Z: coefficient, 0.004; P<0.001 and 
      LGE: coefficient, 0.04; P<0.001) but not in ablation-naive patients. In contrast, 
      increased LA electrogram fractionation was associated with SI-Z (coefficient, 
      0.012; P=0.03) and LGE (coefficient, 0.035; P<0.001) only in ablation-naive 
      patients. CONCLUSIONS: The association of LA LGE with voltage is modified by 
      ablation. Importantly, in ablation-naive patients, atrial LGE is associated with 
      electrogram fractionation even in the absence of voltage abnormalities.
FAU - Kuo, Ling
AU  - Kuo L
AD  - Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 
      Taiwan (L.K.).
AD  - Department of Medicine, National Yang-Ming University School of Medicine, Taipei, 
      Taiwan (L.K.).
AD  - Electrophysiology Section, Cardiovascular Division, Department of Medicine (L.K., 
      E.Z., D.F., P.S., J.A., F.E.M., S.N.), Perelman School of Medicine at the 
      University of Pennsylvania, Philadelphia.
FAU - Zado, Erica
AU  - Zado E
AD  - Electrophysiology Section, Cardiovascular Division, Department of Medicine (L.K., 
      E.Z., D.F., P.S., J.A., F.E.M., S.N.), Perelman School of Medicine at the 
      University of Pennsylvania, Philadelphia.
FAU - Frankel, David
AU  - Frankel D
AD  - Electrophysiology Section, Cardiovascular Division, Department of Medicine (L.K., 
      E.Z., D.F., P.S., J.A., F.E.M., S.N.), Perelman School of Medicine at the 
      University of Pennsylvania, Philadelphia.
FAU - Santangeli, Pasquale
AU  - Santangeli P
AD  - Electrophysiology Section, Cardiovascular Division, Department of Medicine (L.K., 
      E.Z., D.F., P.S., J.A., F.E.M., S.N.), Perelman School of Medicine at the 
      University of Pennsylvania, Philadelphia.
FAU - Arkles, Jeffrey
AU  - Arkles J
AD  - Electrophysiology Section, Cardiovascular Division, Department of Medicine (L.K., 
      E.Z., D.F., P.S., J.A., F.E.M., S.N.), Perelman School of Medicine at the 
      University of Pennsylvania, Philadelphia.
FAU - Han, Yuchi
AU  - Han Y
AD  - Cardiovascular Division, Department of Medicine (Y.H.), Perelman School of 
      Medicine at the University of Pennsylvania, Philadelphia.
FAU - Marchlinski, Francis E
AU  - Marchlinski FE
AD  - Electrophysiology Section, Cardiovascular Division, Department of Medicine (L.K., 
      E.Z., D.F., P.S., J.A., F.E.M., S.N.), Perelman School of Medicine at the 
      University of Pennsylvania, Philadelphia.
FAU - Nazarian, Saman
AU  - Nazarian S
AD  - Electrophysiology Section, Cardiovascular Division, Department of Medicine (L.K., 
      E.Z., D.F., P.S., J.A., F.E.M., S.N.), Perelman School of Medicine at the 
      University of Pennsylvania, Philadelphia.
FAU - Desjardins, Benoit
AU  - Desjardins B
AD  - Cardiovascular Imaging Section, Department of Radiology (B.D), Perelman School of 
      Medicine at the University of Pennsylvania, Philadelphia.
LA  - eng
GR  - R01 HL116280/HL/NHLBI NIH HHS/United States
GR  - R01 HL142893/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20200115
PL  - United States
TA  - Circ Arrhythm Electrophysiol
JT  - Circulation. Arrhythmia and electrophysiology
JID - 101474365
RN  - 0 (Contrast Media)
RN  - 0 (Organometallic Compounds)
RN  - 6HG8UB2MUY (Meglumine)
RN  - L0ND3981AG (gadoterate meglumine)
SB  - IM
EIN - Circ Arrhythm Electrophysiol. 2022 Oct;15(10):e000085. Frankel, DS [corrected to 
      Frankel, D]. PMID: 36256733
EIN - Circ Arrhythm Electrophysiol. 2023 Mar;16(3):e000087. PMID: 36943920
MH  - Atrial Fibrillation/*diagnostic imaging/*physiopathology/surgery
MH  - Catheter Ablation
MH  - Contrast Media/administration & dosage
MH  - *Electrocardiography
MH  - Epicardial Mapping
MH  - Female
MH  - Humans
MH  - Imaging, Three-Dimensional
MH  - Magnetic Resonance Angiography/*methods
MH  - Male
MH  - Meglumine/administration & dosage
MH  - Middle Aged
MH  - Organometallic Compounds/administration & dosage
MH  - Prospective Studies
PMC - PMC7031051
MID - NIHMS1549822
OTO - NOTNLM
OT  - atrial fibrillation
OT  - heart atria
OT  - humans
OT  - magnetic resonance imaging
OT  - myocardium
EDAT- 2020/01/16 06:00
MHDA- 2020/08/18 06:00
PMCR- 2021/02/01
CRDT- 2020/01/16 06:00
PHST- 2020/01/16 06:00 [pubmed]
PHST- 2020/08/18 06:00 [medline]
PHST- 2020/01/16 06:00 [entrez]
PHST- 2021/02/01 00:00 [pmc-release]
AID - 10.1161/CIRCEP.119.007586 [doi]
PST - ppublish
SO  - Circ Arrhythm Electrophysiol. 2020 Feb;13(2):e007586. doi: 
      10.1161/CIRCEP.119.007586. Epub 2020 Jan 15.