Study shows potential usefulness of non-invasive measure of heart tissue scarring

Scarring of tissue in the upper chamber of the heart (atrium) was associated with recurrent rhythm disorder after treatment, according to a study in the February 5 issue of JAMA.

Left atrial fibrosis (formation of scar tissue in the heart) is prominent in with (AF), according to background information in the article. Extensive atrial tissue fibrosis identified by delayed enhancement magnetic resonance imaging (MRI) has been associated with poor outcomes of AF , a procedure in which electrical energy is used to treat AF.

Nassir F. Marrouche, M.D., of the University of Utah School of Medicine, Salt Lake City, and colleagues conducted a study to characterize the feasibility of measuring atrial scar tissue using delayed enhancement (MRI), and assessed the association between the amount of and response to ablation. The study was conducted between August 2010 and August 2011 at 15 centers in the United States, Europe, and Australia; delayed enhancement MRI images were obtained up to 30 days before ablation.

There were 329 patients enrolled in the study; 57 patients (17.3 percent) were excluded due to poor MRI quality. The researchers found that the incidence of recurrence increased with the amount of scarring, from 15.3 percent recurrence at day 325 with less than 10 percent scarring of the atrial wall to 51.1 percent recurrence for 30 percent or greater scarring.

The authors write that this study demonstrates the feasibility and potential clinical value of using delayed enhancement MRI in the management of patients with AF considered for ablation. "In current practice, criteria for selecting good candidates for AF ablation are limited." They add that the amount of left atrial wall fibrosis estimated by delayed enhancement MRI has the potential to offer a noninvasive and effective method for determining which patients with AF are likely to benefit from while avoiding procedures in patients likely to have arrhythmia recurrence.

More information: DOI: 10.1001/jama.2014.3

Related Stories

GAP-AF study helps to define optimal approach to ablation

date Jun 25, 2013

(Medical Xpress)—Using catheter ablation to create complete linear lesions around pulmonary veins, proved more effective than the creation of incomplete lesions in preventing recurrence of atrial fibrillation (AF), reports ...

Recommended for you

Race influences warfarin dose, study says

date 4 hours ago

A new report demonstrates that clinical and genetic factors affecting dose requirements for warfarin vary by race. The study, published online today in Blood, the Journal of the American Society of Hematology (ASH), propose ...

Even moderate BMI reduction could ease A-fib burden

date 7 hours ago

(HealthDay)—Incremental increases in body mass index (BMI) are associated with excess risk of incident, postoperative, and post-ablation atrial fibrillation (AF), according to a review published online ...

Personalized saline may provide solution to heart death

date 9 hours ago

Saline solution is a staple of every hospital. No matter the ailment, doctors have known for more than a century that saline is key to keeping patients hydrated and maintaining their blood pressure levels. ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.