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Arrhythmias & electrophysiologyResearch article

Right Atrial Cardiomyopathy Assessed by Late Gadolinium Enhancement Cardiac MRI Following Pulmonary Vein Isolation in Patients with Atrial Fibrillation

Heart RhythmPublished

  • Patients with atrial fibrillation (AF) underwent pulmonary vein isolation (PVI) and LGE-CMR imaging at baseline and 3 months post-PVI
  • healthy volunteers as controls
  • 1-year AF recurrence assessed
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Authors' conclusion

Compared with the healthy controls, patients with AF exhibited more extensive RA LGE, RA enlargement, and dysfunction, reflecting significant RA myopathy. Furthermore, in patients with AF, average RA-LGE level was similar after PVI, but RA volumes decreased and RA function improved. Notably, patients with reduced RA-LGE level had reverse remodeling, whereas those with increased RA-LGE level did not.

Study context

Population
Patients with AF undergoing pulmonary vein isolation, and healthy volunteers as controlspatients with AF, controls n = 18 · Patients with AF 54 · Healthy volunteers (controls) 18
Participants
54 patients
Comparison
Patients with AF vs controls
  • Patients with AFn = 54
  • controlsn = 18

Main finding

As reported in the abstract

RA-LGE level

P < 0.001

Further findings

RAVImax · larger in patients with AF

P = 0.01

RA emptying fraction · lower in patients with AF

P < 0.001

Total, border-zone, and dense RA-LGE levels · baseline and 3 months post-PVI

Similar at baseline and 3 months post-PVI among patients with AF

Indexed 3D right atrial (RA) volume · baseline to post-PVI

Baseline
58.4 ± 16.5 mL/m²
Post-PVI
53.8 ± 14.0 mL/m²
P
P < 0.001
  • RA volumes decreased post-PVI

RA reservoir strain · baseline to post-PVI

Baseline
17.1 ± 4.6%
Post-PVI
18.9 ± 3.7%
P
P = 0.03
  • increased compared with baseline

Interindividual variability in RA-LGE changes

only patients with decreased RA-LGE level post-PVI had reverse RA remodeling

Total RA-LGE level by AF recurrence · 1 year

Patients with AF recurrence
n = 21, 38.9%
Total RA-LGE level increased in patients with AF recurrence and remained unchanged in those without recurrence

Original publication

Right Atrial Cardiomyopathy Assessed by Late Gadolinium Enhancement Cardiac MRI Following Pulmonary Vein Isolation in Patients with Atrial Fibrillation. Heart Rhythm. Published 16 September 2026. doi:10.1016/j.hrthm.2026.09.010
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Summarised from the published abstract; every number is checked against it