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Effect of atrial fibrillation ablation on myocardial function: insights from cardiac magnetic resonance feature tracking analysis

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Abstract

Restoration of sinus rhythm may result in an improvement of left heart function in patients with atrial fibrillation (AF). Cardiovascular magnetic resonance (CMR) feature tracking (FT) technique may help detect subtle wall-motion abnormalities. Consequently this study aimed to analyse existence and reversibility of subclinical cardiac dysfunction following atrial fibrillation ablation. 28 consecutive patients (mean age 61 years) with paroxysmal AF underwent pulmonary vein isolation. CMR imaging was done 3 (±3) days before and 3.4 (±1.1) months after ablation. Left heart function was determined by performing FT analysis. Statistical analysis included paired student’s t test, random effects metaanalysis to assess the cohort’s health status and Bland–Altman analysis. 17 patients (61 %) were free from AF at follow-up. Bland–Altman analysis showed good coefficients of variation. Of all 195 parameters, 27 changed (14 %):9 improved significantly (5 %), 12 worsened significantly (6 %), whereas 6 parameters worsened not significantly (3 %). 18 of 120 systolic parameters changed (15 %), 14 worsened (12 %), 4 improved (3 %). In 9 of 75 diastolic parameters, values changed (12 %): 5 improved (7 %) and 4 worsened (5 %). Meta-analysis revealed that our collective’s FT values at baseline didn’t differ significantly from healthy volunteers’ values [Q values of 0.01 (p value 0.921) and 1.499 (p value 0.221)]. AF patients undergoing ablation appear to have near normal cardiac wall motion, which does not improve following successful ablation. Feature tracking analysis is a reliable tool to determine treatment effects but is more likely to show positive findings if the population is unhealthy.

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References

  1. Arbelo E, Brugada J, Hindricks G, Maggioni A, Tavazzi L, Vardas P, Anselme F, Inama G, Jais P, Kalarus Z, Kautzner J, Lewalter T, Mairesse G, Perez-Villacastin J, Riahi S, Taborsky M, Theodorakis G, Trines S (2012) ESC-EUR observational research programme: the atrial fibrillation ablation pilot study, conducted by the European heart rhythm association. Europace 14(8):1094–1103. doi:10.1093/europace/eus153

    Article  PubMed  Google Scholar 

  2. Tops LF, Bax JJ, Zeppenfeld K, Jongbloed MR, van der Wall EE, Schalij MJ (2006) Effect of radiofrequency catheter ablation for atrial fibrillation on left atrial cavity size. Am J Cardiol 97(8):1220–1222. doi:10.1016/j.amjcard.2005.11.043

    Article  PubMed  Google Scholar 

  3. Reant P, Lafitte S, Jais P, Serri K, Weerasooriya R, Hocini M, Pillois X, Clementy J, Haissaguerre M, Roudaut R (2005) Reverse remodelling of the left cardiac chambers after catheter ablation after 1 year in a series of patients with isolated atrial fibrillation. Circulation 112(19):2896–2903. doi:10.1161/CIRCULATIONAHA.104.523928

    PubMed  Google Scholar 

  4. Morton G, Schuster A, Jogiya R, Kutty S, Beerbaum P, Nagel E (2012) Inter-study reproducibility of cardiovascular magnetic resonance myocardial feature tracking. J Cardiovasc Magn Reson 14:43. doi:10.1186/1532-429X-14-43

    Article  PubMed  Google Scholar 

  5. Morton G, Jogiya R, Plein S, Schuster A, Chiribiri A, Nagel E (2012) Quantitative cardiovascular magnetic resonance perfusion imaging: inter-study reproducibility. Eur Heart J Cardiovasc Imaging 13(11):954–960. doi:10.1093/ehjci/jes103

    Article  PubMed  Google Scholar 

  6. Kempny A, Fernandez-Jimenez R, Orwat S, Schuler P, Bunck AC, Maintz D, Baumgartner H, Diller GP (2012) Quantification of biventricular myocardial function using cardiac magnetic resonance feature tracking, endocardial border delineation and echocardiographic speckle tracking in patients with repaired tetralogy of Fallot and healthy controls. J Cardiovasc Magn Reson 14:32. doi:10.1186/1532-429X-14-32

    Article  PubMed  Google Scholar 

  7. Augustine D, Lewandowski AJ, Lazdam M, Rai A, Francis J, Myerson S, Noble A, Becher H, Neubauer S, Petersen SE, Leeson P (2013) Global and regional left ventricular myocardial deformation measures by magnetic resonance feature tracking in healthy volunteers: comparison with tagging and relevance of gender. J Cardiovasc Magn Reson 15(1):8. doi:10.1186/1532-429X-15-8

    Article  PubMed  Google Scholar 

  8. Hsu LF, Jais P, Sanders P, Garrigue S, Hocini M, Sacher F, Takahashi Y, Rotter M, Pasquie JL, Scavee C, Bordachar P, Clementy J, Haissaguerre M (2004) Catheter ablation for atrial fibrillation in congestive heart failure. N Engl J Med 351(23):2373–2383. doi:10.1056/NEJMoa041018

    Article  CAS  PubMed  Google Scholar 

  9. Gentlesk PJ, Sauer WH, Gerstenfeld EP, Lin D, Dixit S, Zado E, Callans D, Marchlinski FE (2007) Reversal of left ventricular dysfunction following ablation of atrial fibrillation. J Cardiovasc Electrophysiol 18(1):9–14. doi:10.1111/j.1540-8167.2006.00653.x

    Article  PubMed  Google Scholar 

  10. Chen MS, Marrouche NF, Khaykin Y, Gillinov AM, Wazni O, Martin DO, Rossillo A, Verma A, Cummings J, Erciyes D, Saad E, Bhargava M, Bash D, Schweikert R, Burkhardt D, Williams-Andrews M, Perez-Lugones A, Abdul-Karim A, Saliba W, Natale A (2004) Pulmonary vein isolation for the treatment of atrial fibrillation in patients with impaired systolic function. J Am Coll Cardiol 43(6):1004–1009. doi:10.1016/j.jacc.2003.09.056

    Article  PubMed  Google Scholar 

  11. Hunter RJ, Jones DA, Boubertakh R, Malcolme-Lawes LC, Kanagaratnam P, Juli CF, Davies DW, Peters NS, Baker V, Earley MJ, Sporton S, Davies LC, Westwood M, Petersen SE, Schilling RJ (2012) Diagnostic accuracy of cardiac magnetic resonance imaging in the detection and characterization of left atrial catheter ablation lesions: a multicenter experience. J Cardiovasc Electrophysiol. doi:10.1111/jce.12063

    Google Scholar 

  12. Hunter RJ, Berriman TJ, Diab I, Baker V, Finlay M, Richmond L, Duncan E, Kamdar R, Thomas G, Abrams D, Dhinoja M, Sporton S, Earley MJ, Schilling RJ (2010) Long-term efficacy of catheter ablation for atrial fibrillation: impact of additional targeting of fractionated electrograms. Heart 96(17):1372–1378. doi:10.1136/hrt.2009.188128

    Article  CAS  PubMed  Google Scholar 

  13. Calkins H, Kuck KH, Cappato R, Brugada J, Camm AJ, Chen SA, Crijns HJ, Damiano RJ Jr, Davies DW, DiMarco J, Edgerton J, Ellenbogen K, Ezekowitz MD, Haines DE, Haissaguerre M, Hindricks G, Iesaka Y, Jackman W, Jalife J, Jais P, Kalman J, Keane D, Kim YH, Kirchhof P, Klein G, Kottkamp H, Kumagai K, Lindsay BD, Mansour M, Marchlinski FE, McCarthy PM, Mont JL, Morady F, Nademanee K, Nakagawa H, Natale A, Nattel S, Packer DL, Pappone C, Prystowsky E, Raviele A, Reddy V, Ruskin JN, Shemin RJ, Tsao HM, Wilber D (2012) 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Europace 14(4):528–606. doi:10.1093/europace/eus027

    Article  PubMed  Google Scholar 

  14. Papavassiliu T, Kuhl HP, Schroder M, Suselbeck T, Bondarenko O, Bohm CK, Beek A, Hofman MM, van Rossum AC (2005) Effect of endocardial trabeculae on left ventricular measurements and measurement reproducibility at cardiovascular MR imaging. Radiology 236(1):57–64. doi:10.1148/radiol.2353040601

    Article  PubMed  Google Scholar 

  15. Childs H, Ma L, Ma M, Clarke J, Cocker M, Green J, Strohm O, Friedrich MG (2011) Comparison of long and short axis quantification of left ventricular volume parameters by cardiovascular magnetic resonance, with ex vivo validation. J Cardiovasc Magn Reson 13:40. doi:10.1186/1532-429X-13-40

    Article  PubMed  Google Scholar 

  16. Hof IE, Velthuis BK, Van Driel VJ, Wittkampf FH, Hauer RN, Loh P (2010) Left atrial volume and function assessment by magnetic resonance imaging. J Cardiovasc Electrophysiol 21(11):1247–1250. doi:10.1111/j.1540-8167.2010.01805.x

    Article  PubMed  Google Scholar 

  17. Harrild DM, Han Y, Geva T, Zhou J, Marcus E, Powell AJ (2012) Comparison of cardiac MRI tissue tracking and myocardial tagging for assessment of regional ventricular strain. Int J Cardiovasc Imaging 28(8):2009–2018. doi:10.1007/s10554-012-0035-3

    Article  PubMed  Google Scholar 

  18. Alfakih K, Plein S, Thiele H, Jones T, Ridgway JP, Sivananthan MU (2003) Normal human left and right ventricular dimensions for MRI as assessed by turbo gradient echo and steady-state free precession imaging sequences. J Magn Reson Imaging 17(3):323–329. doi:10.1002/jmri.10262

    Article  PubMed  Google Scholar 

  19. Maceira AM, Prasad SK, Khan M, Pennell DJ (2006) Normalized left ventricular systolic and diastolic function by steady state free precession cardiovascular magnetic resonance. J Cardiovasc Magn Reson 8(3):417–426

    Article  CAS  PubMed  Google Scholar 

  20. Hudsmith LE, Petersen SE, Francis JM, Robson MD, Neubauer S (2005) Normal human left and right ventricular and left atrial dimensions using steady state free precession magnetic resonance imaging. J Cardiovasc Magn Reson 7(5):775–782

    Article  PubMed  Google Scholar 

  21. Kadiyala MT, R.; Bertman, K.; Pollack, S.; Reichek, N. (2011) Feature Tracking: a novel method to analyze myocardial strain: Results from the CMR strain study in healthy volunteers. Paper presented at the SCMR/Euro CMR Joint Scientific Sessions, Nice, France, 2 February 2011

  22. Schuster A, Kutty S, Padiyath A, Parish V, Gribben P, Danford DA, Makowski MR, Bigalke B, Beerbaum P, Nagel E (2011) Cardiovascular magnetic resonance myocardial feature tracking detects quantitative wall motion during dobutamine stress. J Cardiovasc Magn Reson 13:58. doi:10.1186/1532-429X-13-58

    Article  PubMed  Google Scholar 

  23. Schuster A, Morton G, Hussain ST, Jogiya R, Kutty S, Asrress KN, Makowski MR, Bigalke B, Perera D, Beerbaum P, Nagel E (2013) The intra-observer reproducibility of cardiovascular magnetic resonance myocardial feature tracking strain assessment is independent of field strength. Eur J Radiol 82(2):296–301. doi:10.1016/j.ejrad.2012.11.012

    Article  PubMed  Google Scholar 

  24. Kannel WB, Abbott RD, Savage DD, McNamara PM (1982) Epidemiologic features of chronic atrial fibrillation: the Framingham study. N Engl J Med 306(17):1018–1022. doi:10.1056/NEJM198204293061703

    Article  CAS  PubMed  Google Scholar 

  25. Hunter RJ, Liu Y, Lu Y, Wang W, Schilling RJ (2012) Left atrial wall stress distribution and its relationship to electrophysiologic remodelling in persistent atrial fibrillation. Circ Arrhythm Electrophysiol 5(2):351–360. doi:10.1161/CIRCEP.111.965541

    Article  PubMed  Google Scholar 

  26. Mamas MA, Caldwell JC, Chacko S, Garratt CJ, Fath-Ordoubadi F, Neyses L (2009) A meta-analysis of the prognostic significance of atrial fibrillation in chronic heart failure. Eur J Heart Fail 11(7):676–683. doi:10.1093/eurjhf/hfp085

    Article  PubMed  Google Scholar 

  27. Wang TJ, Larson MG, Levy D, Vasan RS, Leip EP, Wolf PA, D’Agostino RB, Murabito JM, Kannel WB, Benjamin EJ (2003) Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham heart study. Circulation 107(23):2920–2925. doi:10.1161/01.CIR.0000072767.89944.6E

    Article  PubMed  Google Scholar 

  28. Mirza M, Caracciolo G, Khan U, Mori N, Saha SK, Srivathsan K, Altemose G, Scott L, Sengupta P, Jahangir A (2011) Left atrial reservoir function predicts atrial fibrillation recurrence after catheter ablation: a two-dimensional speckle strain study. J Interv Card Electrophysiol 31(3):197–206. doi:10.1007/s10840-011-9560-6

    Article  PubMed  Google Scholar 

  29. Hammerstingl C, Schwekendiek M, Momcilovic D, Schueler R, Sinning JM, Schrickel JW, Mittmann-Braun E, Nickenig G, Lickfett L (2012) Left atrial deformation imaging with ultrasound based two-dimensional speckle-tracking predicts the rate of recurrence of paroxysmal and persistent atrial fibrillation after successful ablation procedures. J Cardiovasc Electrophysiol 23(3):247–255. doi:10.1111/j.1540-8167.2011.02177.x

    Article  PubMed  Google Scholar 

  30. Reant P, Lafitte S, Bougteb H, Sacher F, Mignot A, Douard H, Blanc P, Hocini M, Clementy J, Haissaguerre M, Roudaut R, Jais P (2009) Effect of catheter ablation for isolated paroxysmal atrial fibrillation on longitudinal and circumferential left ventricular systolic function. Am J Cardiol 103(2):232–237. doi:10.1016/j.amjcard.2008.08.070

    Article  PubMed  Google Scholar 

  31. Tops LF, Delgado V, Bertini M, Marsan NA, Den Uijl DW, Trines SA, Zeppenfeld K, Holman E, Schalij MJ, Bax JJ (2011) Left atrial strain predicts reverse remodelling after catheter ablation for atrial fibrillation. J Am Coll Cardiol 57(3):324–331. doi:10.1016/j.jacc.2010.05.063

    Article  PubMed  Google Scholar 

  32. Nagel E, Schneider U, Schalla S, Ibrahim T, Schnackenburg B, Bornstedt A, Klein C, Lehmkuhl HB, Fleck E (2000) Magnetic resonance real-time imaging for the evaluation of left ventricular function. J Cardiovasc Magn Reson 2(1):7–14

    Article  CAS  PubMed  Google Scholar 

  33. Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, Van Gelder IC, Al-Attar N, Hindricks G, Prendergast B, Heidbuchel H, Alfieri O, Angelini A, Atar D, Colonna P, De Caterina R, De Sutter J, Goette A, Gorenek B, Heldal M, Hohloser SH, Kolh P, Le Heuzey JY, Ponikowski P, Rutten FH (2010) Guidelines for the management of atrial fibrillation: the task force for the management of atrial fibrillation of the European society of cardiology (ESC). Eur Heart J 31(19):2369–2429. doi:10.1093/eurheartj/ehq278

    Article  PubMed  Google Scholar 

  34. Schneider C, Malisius R, Krause K, Lampe F, Bahlmann E, Boczor S, Antz M, Ernst S, Kuck KH (2008) Strain rate imaging for functional quantification of the left atrium: atrial deformation predicts the maintenance of sinus rhythm after catheter ablation of atrial fibrillation. Eur Heart J 29(11):1397–1409. doi:10.1093/eurheartj/ehn168

    Article  PubMed  Google Scholar 

  35. Jahnke C, Fischer J, Gerds-Li JH, Gebker R, Manka R, Fleck E, Paetsch I, Kriatselis C (2011) Serial monitoring of reverse left-atrial remodeling after pulmonary vein isolation in patients with atrial fibrillation: a magnetic resonance imaging study. Int J Cardiol 153(1):42–46. doi:10.1016/j.ijcard.2010.08.034

    Article  PubMed  Google Scholar 

  36. Morton G, Schuster A, Jogiya R, Kutty S, Beerbaum P, Nagel E (2012) Inter-study reproducibility of cardiovascular magnetic resonance myocardial feature tracking. J Cardiovasc Magn Reson 14:43. doi:10.1186/1532-429X-14-43

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors declare that they have no competing interests. This work forms part of the research themes contributing to the translational research portfolio of Barts Cardiovascular Biomedical Research Unit which is supported and funded by the National Institute for Health Research.

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Authors and Affiliations

  1. Advanced Cardiovascular Imaging, Centre for Advanced Cardiovascular Imaging, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, The London Chest Hospital, Queen Mary University of London, Bonner Road, London, E2 9JX, UK

    Felix Ceelen, Ross J. Hunter, Redha Boubertakh, Richard J. Schilling & Steffen E. Petersen

  2. Department of Clinical Radiology, University of Munich, Munich, Germany

    Felix Ceelen, Wieland H. Sommer & Marco Armbruster

  3. Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London, UK

    Steffen E. Petersen

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  1. Felix Ceelen
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Correspondence to Steffen E. Petersen.

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Ceelen, F., Hunter, R.J., Boubertakh, R. et al. Effect of atrial fibrillation ablation on myocardial function: insights from cardiac magnetic resonance feature tracking analysis. Int J Cardiovasc Imaging 29, 1807–1817 (2013). https://doi.org/10.1007/s10554-013-0287-6

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  • DOI: https://doi.org/10.1007/s10554-013-0287-6

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