Arrhythmias & electrophysiology

Magnetic resonance detection of advanced atrial cardiomyopathy increases the risk for atypical atrial flutter occurrence following atrial fibrillation ablation

EuropacePublished Cohort study from a prospective registry

Authors' conclusion

Advanced atrial cardiomyopathy assessed by LGE-CMR, such as increased LA sphericity, global LA fibrosis, and fibrosis in the lateral wall, is independently associated with arrhythmia recurrence in the form of AFL following AF ablation.

Study context

Population
Patients with AF recurrence after catheter ablation with baseline LGE-CMR, requiring re-ablationfrom registry cohort of 1007
Participants
166 patients
Exposure
Atrial flutter (AFL) recurrence vs AF recurrence after AF ablation
  • AFLn = 56
  • AFn = 110reference
Outcome
Occurrence of atypical AFL after AF ablation
Methodological detailsconsecutive patients
  • Consecutive patients

Main finding

As reported in the abstract

Independent predictors of AFL recurrence
Age >65
OR 5.6 (95% CI 2.2-14.4)
Number of previous ablations
OR 3.0 (95% CI 1.2-7.8)
Management of ablation lines in index procedure
OR 2.5 (95% CI 1.0-6.3)
Enhanced left atrial (LA) sphericity on LGE-CMR
OR 1.3 (95% CI 1.1-1.6)
LA global fibrosis on LGE-CMR
OR 1.03 (95% CI 1.01-1.07)
Increased lateral wall fibrosis on LGE-CMR
OR 1.03 (95% CI 1.01-1.04)

Observational data: associations, not effects.

Original publication

Magnetic resonance detection of advanced atrial cardiomyopathy increases the risk for atypical atrial flutter occurrence following atrial fibrillation ablation. Europace. Published 26 September 2023. doi:10.1093/europace/euad276

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