Association of Left Atrial Local Conduction Velocity with Late Gadolinium Enhancement on Cardiac Magnetic Resonance in Patients with Atrial Fibrillation

Kotaro Fukumoto, Mohammadali Habibi, Esra Gucuk Ipek, Sohail Zahid, Irfan M. Khurram, Stefan L. Zimmerman, Vadim Zipunnikov, David Spragg, Hiroshi Ashikaga, Natalia Trayanova, Gordon F. Tomaselli, John Rickard, Joseph E. Marine, Ronald D. Berger, Hugh Calkins, Saman Nazarian

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background-Prior studies have demonstrated regional left atrial late gadolinium enhancement (LGE) heterogeneity on magnetic resonance imaging. Heterogeneity in regional conduction velocities is a critical substrate for functional reentry. We sought to examine the association between left atrial conduction velocity and LGE in patients with atrial fibrillation. Methods and Results-LGE imaging and left atrial activation mapping were performed during sinus rhythm in 22 patients before pulmonary vein isolation. The locations of 1468 electroanatomic map points were registered to the corresponding anatomic sites on 469 axial LGE image planes. The local conduction velocity at each point was calculated using previously established methods. The myocardial wall thickness and image intensity ratio defined as left atrial myocardial LGE signal intensity divided by the mean left atrial blood pool intensity was calculated for each mapping site. The local conduction velocity and image intensity ratio in the left atrium (mean±SD) were 0.98±0.46 and 0.95±0.26 m/s, respectively. In multivariable regression analysis, clustered by patient, and adjusting for left atrial wall thickness, conduction velocity was associated with the local image intensity ratio (0.20 m/s decrease in conduction velocity per increase in unit image intensity ratio, P<0.001). Conclusions-In this clinical in vivo study, we demonstrate that left atrial myocardium with increased gadolinium uptake has lower local conduction velocity. Identification of such regions may facilitate the targeting of the substrate for reentrant arrhythmias.

Original languageEnglish (US)
Article numbere002897
JournalCirculation: Arrhythmia and Electrophysiology
Volume9
Issue number3
DOIs
StatePublished - Mar 1 2016
Externally publishedYes

Fingerprint

Gadolinium
Atrial Fibrillation
Magnetic Resonance Spectroscopy
Image Enhancement
Pulmonary Veins
Heart Atria
Cardiac Arrhythmias
Myocardium
Regression Analysis
Magnetic Resonance Imaging

Keywords

  • arrhythmias, cardiac
  • atrial fibrillation
  • fibrosis
  • magnetic resonance imaging
  • regression analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Association of Left Atrial Local Conduction Velocity with Late Gadolinium Enhancement on Cardiac Magnetic Resonance in Patients with Atrial Fibrillation. / Fukumoto, Kotaro; Habibi, Mohammadali; Ipek, Esra Gucuk; Zahid, Sohail; Khurram, Irfan M.; Zimmerman, Stefan L.; Zipunnikov, Vadim; Spragg, David; Ashikaga, Hiroshi; Trayanova, Natalia; Tomaselli, Gordon F.; Rickard, John; Marine, Joseph E.; Berger, Ronald D.; Calkins, Hugh; Nazarian, Saman.

In: Circulation: Arrhythmia and Electrophysiology, Vol. 9, No. 3, e002897, 01.03.2016.

Research output: Contribution to journalArticle

Fukumoto, K, Habibi, M, Ipek, EG, Zahid, S, Khurram, IM, Zimmerman, SL, Zipunnikov, V, Spragg, D, Ashikaga, H, Trayanova, N, Tomaselli, GF, Rickard, J, Marine, JE, Berger, RD, Calkins, H & Nazarian, S 2016, 'Association of Left Atrial Local Conduction Velocity with Late Gadolinium Enhancement on Cardiac Magnetic Resonance in Patients with Atrial Fibrillation', Circulation: Arrhythmia and Electrophysiology, vol. 9, no. 3, e002897. https://doi.org/10.1161/CIRCEP.115.002897
Fukumoto, Kotaro ; Habibi, Mohammadali ; Ipek, Esra Gucuk ; Zahid, Sohail ; Khurram, Irfan M. ; Zimmerman, Stefan L. ; Zipunnikov, Vadim ; Spragg, David ; Ashikaga, Hiroshi ; Trayanova, Natalia ; Tomaselli, Gordon F. ; Rickard, John ; Marine, Joseph E. ; Berger, Ronald D. ; Calkins, Hugh ; Nazarian, Saman. / Association of Left Atrial Local Conduction Velocity with Late Gadolinium Enhancement on Cardiac Magnetic Resonance in Patients with Atrial Fibrillation. In: Circulation: Arrhythmia and Electrophysiology. 2016 ; Vol. 9, No. 3.
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abstract = "Background-Prior studies have demonstrated regional left atrial late gadolinium enhancement (LGE) heterogeneity on magnetic resonance imaging. Heterogeneity in regional conduction velocities is a critical substrate for functional reentry. We sought to examine the association between left atrial conduction velocity and LGE in patients with atrial fibrillation. Methods and Results-LGE imaging and left atrial activation mapping were performed during sinus rhythm in 22 patients before pulmonary vein isolation. The locations of 1468 electroanatomic map points were registered to the corresponding anatomic sites on 469 axial LGE image planes. The local conduction velocity at each point was calculated using previously established methods. The myocardial wall thickness and image intensity ratio defined as left atrial myocardial LGE signal intensity divided by the mean left atrial blood pool intensity was calculated for each mapping site. The local conduction velocity and image intensity ratio in the left atrium (mean±SD) were 0.98±0.46 and 0.95±0.26 m/s, respectively. In multivariable regression analysis, clustered by patient, and adjusting for left atrial wall thickness, conduction velocity was associated with the local image intensity ratio (0.20 m/s decrease in conduction velocity per increase in unit image intensity ratio, P<0.001). Conclusions-In this clinical in vivo study, we demonstrate that left atrial myocardium with increased gadolinium uptake has lower local conduction velocity. Identification of such regions may facilitate the targeting of the substrate for reentrant arrhythmias.",
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AU - Fukumoto, Kotaro

AU - Habibi, Mohammadali

AU - Ipek, Esra Gucuk

AU - Zahid, Sohail

AU - Khurram, Irfan M.

AU - Zimmerman, Stefan L.

AU - Zipunnikov, Vadim

AU - Spragg, David

AU - Ashikaga, Hiroshi

AU - Trayanova, Natalia

AU - Tomaselli, Gordon F.

AU - Rickard, John

AU - Marine, Joseph E.

AU - Berger, Ronald D.

AU - Calkins, Hugh

AU - Nazarian, Saman

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Background-Prior studies have demonstrated regional left atrial late gadolinium enhancement (LGE) heterogeneity on magnetic resonance imaging. Heterogeneity in regional conduction velocities is a critical substrate for functional reentry. We sought to examine the association between left atrial conduction velocity and LGE in patients with atrial fibrillation. Methods and Results-LGE imaging and left atrial activation mapping were performed during sinus rhythm in 22 patients before pulmonary vein isolation. The locations of 1468 electroanatomic map points were registered to the corresponding anatomic sites on 469 axial LGE image planes. The local conduction velocity at each point was calculated using previously established methods. The myocardial wall thickness and image intensity ratio defined as left atrial myocardial LGE signal intensity divided by the mean left atrial blood pool intensity was calculated for each mapping site. The local conduction velocity and image intensity ratio in the left atrium (mean±SD) were 0.98±0.46 and 0.95±0.26 m/s, respectively. In multivariable regression analysis, clustered by patient, and adjusting for left atrial wall thickness, conduction velocity was associated with the local image intensity ratio (0.20 m/s decrease in conduction velocity per increase in unit image intensity ratio, P<0.001). Conclusions-In this clinical in vivo study, we demonstrate that left atrial myocardium with increased gadolinium uptake has lower local conduction velocity. Identification of such regions may facilitate the targeting of the substrate for reentrant arrhythmias.

AB - Background-Prior studies have demonstrated regional left atrial late gadolinium enhancement (LGE) heterogeneity on magnetic resonance imaging. Heterogeneity in regional conduction velocities is a critical substrate for functional reentry. We sought to examine the association between left atrial conduction velocity and LGE in patients with atrial fibrillation. Methods and Results-LGE imaging and left atrial activation mapping were performed during sinus rhythm in 22 patients before pulmonary vein isolation. The locations of 1468 electroanatomic map points were registered to the corresponding anatomic sites on 469 axial LGE image planes. The local conduction velocity at each point was calculated using previously established methods. The myocardial wall thickness and image intensity ratio defined as left atrial myocardial LGE signal intensity divided by the mean left atrial blood pool intensity was calculated for each mapping site. The local conduction velocity and image intensity ratio in the left atrium (mean±SD) were 0.98±0.46 and 0.95±0.26 m/s, respectively. In multivariable regression analysis, clustered by patient, and adjusting for left atrial wall thickness, conduction velocity was associated with the local image intensity ratio (0.20 m/s decrease in conduction velocity per increase in unit image intensity ratio, P<0.001). Conclusions-In this clinical in vivo study, we demonstrate that left atrial myocardium with increased gadolinium uptake has lower local conduction velocity. Identification of such regions may facilitate the targeting of the substrate for reentrant arrhythmias.

KW - arrhythmias, cardiac

KW - atrial fibrillation

KW - fibrosis

KW - magnetic resonance imaging

KW - regression analysis

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