Cardiac Tissue Characterization with Advanced MRI for Quantifying the Substrate of Atrial Fibrillation and Predicting Outcomes following Catheter Ablation


Atrial fibrillation (AF) is the most common arrhythmia in adults in the United States. Despite its prevalence, the etiology of AF and its adverse effects are not completely understood, which has made treatment of AF difficult. However, left atrial (LA) fibrosis is associated with worsening and propagating AF. Additionally, research has demonstrated a relationship between AF and fibrosis in the left ventricle (LV). While quantifying fibrosis in the heart is challenging, advances in magnetic resonance imaging (MRI) afford noninvasive detection of cardiac fibrosis. Unfortunately, these MRI techniques are not optimal for patients with arrhythmia or for quantifying fibrosis in thin cardiac structures, such as the LA. The purpose of this work was to better understand the relationship between AF and LV fibrosis and to develop a sequence to quantify fibrosis in the LA. An arrhythmia-insensitive MRI sequence was used to understand the relationship between AF and LV fibrosis. Furthermore, a study was performed to determine whether LV fibrosis in patients with AF is predictive of success of catheter ablation procedures. The results demonstrate that there is no correlation between AF and LV fibrosis, and thus LV fibrosis is not predictive of catheter ablation success. Additionally, a high resolution MRI sequence was developed for quantifying LA fibrosis using 3D late gadolinium enhancement at 1.5 T with a short scan time (6 min).

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