Arrhythmias & electrophysiology
Optimal Threshold and Interpatient Variability in Left Atrial Ablation Scar Assessment by Dark-Blood Late Gadolinium Enhancement (LGE) Cardiac Magnetic Resonance (CMR)
Authors' conclusion
The optimal IIR threshold to identify LA ablation scar by dark-blood LGE CMR is 1.09.
Study context
- Population
- Patients scheduled for AF ablation
- Participants
- 54 patients
- Comparison
- Dark-blood LGE CMR IIR thresholds vs bipolar voltage for left atrium (LA) ablation scar
- No previous ablationn = 26
- Previous AF ablationn = 28
- Outcome
- Optimal IIR threshold of dark-blood LGE CMR to identify LA ablation scar (BiV ≤0.15 mV) by ROC analysis
Performance
As reported in the abstract
Optimal IIR threshold for LA ablation scar (BiV ≤0.15 mV)
| Test or model | Value | Sensitivity (average) | Specificity (average) | Accuracy (average) |
|---|---|---|---|---|
| IIR | median optimal threshold 1.09 | 0.73 | 0.75 | 0.71 |
IIR
Valuemedian optimal threshold 1.09
Sensitivity (average)0.73
Specificity (average)0.75
Accuracy (average)0.71
- Median AUC of IIR vs bipolar voltage (BiV) by ROC analysis
- 0.77
Further findings
| Outcome | Values |
|---|---|
| Upper limit of normal IIR (95th and 98th percentiles) for detecting LA ablation scarLow sensitivities | IIR upper limit of normal 1.16 and 1.21 · Sensitivity 0.32 and 0.09 |
IIR thresholds for 80% sensitivity and 80% specificity
- Median IIR threshold for 80% sensitivity
- 1.00
- Median IIR threshold for 80% specificity
- 1.10
Interpatient variability of optimal IIR threshold
- Considerable interpatient variability; optimal IIR thresholds per patient ranged
- 1.01 to 1.22
Original publication
Optimal Threshold and Interpatient Variability in Left Atrial Ablation Scar Assessment by Dark-Blood LGE CMR. JACC Clin Electrophysiol. Published 10 July 2024. doi:10.
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