Abstract:
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.
journal_name
Heart Rhythmjournal_title
Heart rhythmauthors
Malcolme-Lawes LC,Juli C,Karim R,Bai W,Quest R,Lim PB,Jamil-Copley S,Kojodjojo P,Ariff B,Davies DW,Rueckert D,Francis DP,Hunter R,Jones D,Boubertakh R,Petersen SE,Schilling R,Kanagaratnam P,Peters NSdoi
10.1016/j.hrthm.2013.04.030subject
Has Abstractpub_date
2013-08-01 00:00:00pages
1184-91issue
8eissn
1547-5271issn
1556-3871pii
S1547-5271(13)00508-0journal_volume
10pub_type
杂志文章,多中心研究相关文献
HEART RHYTHM文献大全abstract:BACKGROUND:Atrial fibrillation (AF) contributes to increased risk of morbidity and mortality. Data regarding the effectiveness of implantable cardioverter-defibrillator (ICD) therapy in AF patients are limited. OBJECTIVES:The purpose of this study was to evaluate the effectiveness of ICD therapy in patients with AF en...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2006.02.012
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:The extent of left atrial (LA) late gadolinium enhancement (LGE), as a surrogate for fibrosis, has been associated with atrial fibrillation (AF) recurrence after catheter ablation. Furthermore, there is ex vivo evidence that islands of fibrosis may anchor fibrillatory rotors. OBJECTIVE:The purpose of this s...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2015.11.011
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study is to ascertain the effects of spatially variable ACh distributions on arrhythmogenesis in a morphologically realistic computer model of canine atria. BACKGROUND:Vagal stimulation releases acetylcholine (ACh), which causes a dose-dependent reduction in action potential duration (APD...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2004.03.077
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVES:To evaluate the feasibility and outcome of ablation to transect the anterior left atrium (LA) in patients with atrial fibrillation (AF). BACKGROUND:While the Maze procedure is effective in maintaining sinus rhythm in patients with AF, it is associated with significant morbidity. This prospective clinical st...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2004.03.072
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Microvolt T-wave alternans (MTWA) is a valuable tool for stratification of patients at risk for sudden death and has recently been approved for this purpose by Medicare. Although right atrial (RA) pacing has been applied for MTWA testing, the effects of other pacing modalities on MTWA have not been systemati...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2007.10.032
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Termination of persistent atrial fibrillation (AF) is a valuable ablation endpoint but is difficult to anticipate. We evaluated whether temporal and spatial indices of AF regularization predict intraprocedural AF termination and outcome. OBJECTIVE:The purpose of this study was to test whether temporospatial...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2011.05.008
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVES:This study was designed to determine whether ionic currents in right ventricular myocytes from explanted human transplant recipient hearts are related to right ventricular histopathology and function. BACKGROUND:Cardiac action potential duration (APD) is prolonged in ventricular tissues/cells from patients ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2004.06.003
更新日期:2004-10-01 00:00:00
abstract::Newer generations of pacemakers and implantable cardioverter defibrillators have enhanced diagnostic features that permit detection and storage of information about the frequency, duration, time of onset, and rate characteristics of multiple consecutive episodes of atrial tachycardia and atrial fibrillation (AF). Para...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2004.03.075
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to test the hypothesis that on the epicardium of the in vivo human heart, ventricular fibrillation (VF) consists of chaotic small wavefronts that constantly change paths. BACKGROUND:Despite the significance of VF to cardiovascular mortality, little is known about the wavefront...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2004.01.007
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:The degree of QT prolongation by drug is highly variable and related to risk for polymorphic ventricular tachycardia due to drugs. OBJECTIVE:The purpose of this study was to determine factors that affect the degree of QT prolongation by drugs. METHODS:QT and QTc were measured before and after administratio...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2011.03.042
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to assess the long-term effects of ablation of infarct-related ventricular tachycardia (VT) and the subsequent requirement for implantable cardioverter-defibrillator (ICD) therapy. BACKGROUND:The long-term consequences after initially successful catheter ablation of infarct-rel...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2005.01.017
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:In normal atrial and ventricular tissue, the electrical wavefronts are mediated by the fast sodium current (I(Na)), whereas in sinoatrial and atrioventricular nodal tissue, conduction is mediated by the slow L-type calcium current (I(Ca,L)). However, it has not been shown whether the same tissue can exhibit ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2011.08.014
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:The ionic mechanisms underlying action potential duration alternans are not established. OBJECTIVES:The purpose of this study was to explore the mechanisms underlying action potential alternans. METHODS:Computer simulations were performed using a model of a single ischemic myocyte. To emulate ischemia, ext...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2005.11.016
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Obstructive sleep apnea (OSA) causes negative tracheal pressure (NTP) and is associated with atrial fibrillation (AF). OBJECTIVE:This study aimed to determine the mechanism of atrial electrophysiological changes during tracheal occlusion with or without applied NTP and to evaluate the role of vagal activati...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2011.03.053
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine if AV delay optimization with continuous-wave Doppler aortic velocity-time integral (VTI) is clinically superior to an empiric program in patients treated with cardiac resynchronization therapy (CRT) for severe heart failure. BACKGROUND:The impact of AV delay progr...
journal_title:Heart rhythm
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.hrthm.2004.07.006
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Vernakalant inhibits several potassium currents and causes a rate- and voltage-dependent inhibition of the sodium current. OBJECTIVE:The aim of this study was to evaluate the antiarrhythmic mechanism of vernakalant in normal and electrically remodeled atria. METHODS:Fourteen goats were instrumented with el...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2015.12.009
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:The number of lead extractions is growing because of the greater population and increasing age of individuals with a cardiac implantable electronic device. Lead extraction procedures can be complex undertakings with risk of significant mortality, and vascular tears in the superior vena cava are of greatest c...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2020.01.003
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Ventricular tachyarrhythmias are an important cause of morbidity and mortality in cardiac sarcoidosis. To date, the prevalence and incidence of ventricular tachycardia/ventricular fibrillation (VT/VF) in this population remain unknown. OBJECTIVES:To determine the prevalence and incidence of ventricular tach...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2012.02.010
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:The apamin-sensitive small-conductance calcium-activated K (SK) current IKAS modulates automaticity of the sinus node. IKAS blockade by apamin causes sinus bradycardia. OBJECTIVE:The purpose of this study was to test the hypothesis that IKAS modulates ventricular automaticity. METHODS:We tested the effects...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2018.10.033
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Diabetes and obesity are associated with an increased risk of arrhythmia and sudden cardiac death. Abnormal lipid accumulation is observed in cardiomyocytes of obese and diabetic patients, which may contribute to arrhythmia, but the mechanisms are poorly understood. A transgenic mouse model of cardiac lipid ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2016.05.002
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Cardiac resynchronization therapy (CRT) reduces mortality, improves functional status, and induces reverse left ventricular remodeling in selected populations with heart failure (HF). The magnitude of reverse remodeling predicts survival with many HF medical therapies. However, there are few studies assessin...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.hrthm.2014.11.014
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:We previously showed that the cardioversion threshold (CVT) for ventricular tachycardia (VT) is phase dependent when a single monophasic shock (1MP) is used. OBJECTIVE:The purpose of this study was to extend these findings to a biphasic shock (1BP) and to compare the efficacy of phase-independent multiple m...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2009.03.015
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Ablation of long-standing persistent atrial fibrillation (AF) is highly variable, with differing techniques and outcomes. OBJECTIVE:The purpose of this study was to undertake a systematic review of the literature with regard to the impact of ablation technique on the outcomes of long-standing persistent AF ...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2010.01.017
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Therapeutic hypothermia (TH) may increase the susceptibility to ventricular arrhythmias by decreasing ventricular conduction velocity (CV) and facilitating arrhythmogenic spatially discordant alternans (SDA). OBJECTIVE:The purpose of this study was to test the hypothesis that rotigaptide, a gap junction enh...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2015.07.023
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:The reported complication rate of catheter ablation of atrial fibrillation (AF) varies. OBJECTIVE:Our goal was to assess temporal trends and the effect of both institutional and individual operators' experience on the incidence of complications. METHODS:All patients undergoing AF ablation at Johns Hopkins ...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2011.07.025
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Autonomic regulation therapy (ART) with chronic vagus nerve stimulation improves ventricular function in patients with chronic heart failure, but its effects on quantitative T-wave alternans (TWA), ventricular tachycardia (VT), baroreflex sensitivity, and autonomic tone remained unknown. OBJECTIVE:Effects o...
journal_title:Heart rhythm
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.hrthm.2015.11.030
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Reciprocal ST-segment depression simulating additional subendocardial ischemia is commonly observed in ST-segment elevation myocardial infarction. OBJECTIVE:To study the mechanism and characterization of the whole reciprocal electrocardiogram (ECG) patterns induced by acute coronary artery occlusion at diff...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2013.02.022
更新日期:2013-06-01 00:00:00
abstract::Cardiac resynchronization therapy (CRT) is an electrical treatment of heart failure with reduced ejection fraction and wide QRS. It aims to correct the electrical dyssynchrony present in 30% to 50% of patients in this population. Dyssynchrony results in widening of the QRS complex on the electrocardiogram (ECG). CRT w...
journal_title:Heart rhythm
pub_type: 杂志文章,评审
doi:10.1016/j.hrthm.2015.01.023
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Radiofrequency ablation of epicardial and mid-myocardial ventricular arrhythmias is limited by lesion depth. OBJECTIVE:The purpose of this study was to generate deep mid-interventricular septal (IVS) lesions using high-intensity ultrasound (US) from an endocardial catheter-based approach. METHODS:Irrigated...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2020.12.027
更新日期:2020-12-29 00:00:00
abstract:BACKGROUND:Magnetic resonance imaging (MRI) has been performed safely in patients without MRI-conditional cardiac implantable electronic devices (CIEDs), but experience specifically with cardiac magnetic resonance imaging (CMR) is limited in this patient population. OBJECTIVE:Evaluate the safety of CMR in non-MRI-cond...
journal_title:Heart rhythm
pub_type: 杂志文章
doi:10.1016/j.hrthm.2017.10.003
更新日期:2018-02-01 00:00:00