Author + information
- Received March 24, 2017
- Revision received July 3, 2017
- Accepted July 6, 2017
- Published online January 15, 2018.
- Koji Higuchi, MD,
- Joshua Cates, PhD,
- Gregory Gardner, BSc,
- Alan Morris, MSc,
- Nathan S. Burgon, BSc,
- Nazem Akoum, MD and
- Nassir F. Marrouche, MD∗ ()
- Comprehensive Arrhythmia and Research Management (CARMA) Center, University of Utah School of Medicine, Salt Lake City, Utah
- ↵∗Address for correspondence:
Dr. Nassir F. Marrouche, CARMA Center, University of Utah Health Sciences Center, 30 North 1900 East, Room 4A100, Salt Lake City, Utah 84132.
Objectives The purpose of this study is to evaluate the spatial distribution of late gadolinium enhancement (LGE) of the left atrium (LA) by LGE-magnetic resonance imaging in an atrial fibrillation (AF) population.
Background LGE of the LA can be a surrogate of pre-existing structural remodeling of LA.
Methods LGE-magnetic resonance imaging scans were used for 160 patients with AF (mean age 66 ± 11 years) before AF ablation. To know the spatial distribution of LGE, the extent of LGE in 6 LA subregions was examined. Overall LGE distribution was also summarized as a spatial frequency histogram using an atlas of LA shape. These data were also compared between paroxysmal AF (87 patients) and persistent AF (73 patients).
Results LGE coverage (%) in each subregion was as follows: 41.8 ± 18.9% in the left pulmonary vein (PV) antrum, 27.1 ± 16.7% in the left lateral wall, 25.8 ± 15.3% in the posterior wall, 19.7 ± 15.3% in the anterior wall, 17.1 ± 15.0% in the right PV antrum, and 12.0 ± 13.2% in the septum wall. LGE was heterogeneously distributed in the LA and was found with the highest frequency in the posterior wall near the inferior left PV antrum by the LGE histogram. A comparison of paroxysmal AF with persistent AF suggests that LGE was more expected in persistent AF compared with paroxysmal AF, particularly with a spread on the posterior and the anterior wall.
Conclusions LGE in the LA was heterogeneously distributed. LGE was highly distributed in the inferior left PV antrum near the posterior wall side, and spread on the posterior and anterior wall with AF progression.
Dr. Marrouche is a stock holder of MARREK, Inc., which is a main developer of Corview software. Dr. Morris has equity interest in MARREK, Inc. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
All authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received March 24, 2017.
- Revision received July 3, 2017.
- Accepted July 6, 2017.
- 2018 American College of Cardiology Foundation
This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click Login or the Subscribe link (top menu above) to access this article.