Toward better patient selection for ablation: a new method for measuring atrial fibrosis

Abstract

The identification of pulmonary vein triggers in patients with paroxysmal atrial fibrillation (AF) by Haissaguerre et al 1 Haissaguerre M. Jais P. Shah D.C. et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med. 1998; 339: 659-666 Crossref PubMed Scopus (6208) Google Scholar in 1998 led to the development and subsequent worldwide spread of catheter ablation procedures for the treatment of AF. As the procedure has been modified and refined over the past 15 years, it has become a common treatment for patients with symptomatic AF. However, despite technical advances and innovative tools, the success rates of ablation for AF remain relatively modest, particularly in patients with persistent AF. 2 Calkins H. Kuck K.H. Cappato R. et al. 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design: a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation. Developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC) and the European Cardiac Arrhythmia Society (ECAS); and in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS). Endorsed by the governing bodies of the American College of Cardiology Foundation, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, the Asia Pacific Heart Rhythm Society, and the Heart Rhythm Society. Heart Rhythm. 2012; 9 (e621): 632-696 Abstract Full Text Full Text PDF PubMed Scopus (1400) Google Scholar Predicting which patients will benefit from this procedure is challenging for the clinician counseling a patient faced with a variety of options for management of AF. Cardiac magnetic resonance T1 mapping of left atrial myocardiumHeart RhythmVol. 10Issue 9PreviewCardiac magnetic resonance (CMR) T1 mapping is an emerging tool for objective quantification of myocardial fibrosis. Full-Text PDF