Ullrich Ebersberger MD, Presenter: Nothing to Disclose

Michael Bernard, Abstract Co-Author: Nothing to Disclose

U. Joseph Schoepf MD, Abstract Co-Author: Research Grant, Bracco Group Research Grant, Bayer AG Research Grant, General Electric Company Research Grant, Siemens AG

Andrew Douglas McQuiston BS, Abstract Co-Author: Nothing to Disclose

John Wharton, Abstract Co-Author: Nothing to Disclose

William Wince, Abstract Co-Author: Nothing to Disclose

Philipp Blanke MD, Abstract Co-Author: Nothing to Disclose

Yining Wang MD, Abstract Co-Author: Nothing to Disclose

Lucas L. Geyer MD, Abstract Co-Author: Speaker, General Electric Company

Justin R. Silverman, Abstract Co-Author: Nothing to Disclose

James Cranston Gray BA, Abstract Co-Author: Nothing to Disclose

Ellen Hoffmann, Abstract Co-Author: Nothing to Disclose

Several smaller studies report pulmonary vein (PV) contractility as a marker for recurrence after ablation therapy in patients with atrial fibrillation (AF). We sought to validate this observation in a larger, well-characterized patient cohort. Accordingly, we investigated the role of PV contraction patterns on dynamic CT imaging for predicting procedural success of wide area circumferential radiofrequency ablation (WACA) in patients with AF. 

We evaluated data of 260 patients with AF who had undergone WACA. All patients routinely underwent 30 day holter-ECG to assess procedural success as well as retrospectively ECG-gated cardiac dual-source CT to exclude post-procedural complications. Additionally, we evaluated CT data of 30 control subjects without AF. Using serial CT reconstructions across the cardiac cycle, measurements were performed in a plane perpendicular to the centerline of each PV at 10mm from the junction of the PV and the left atrium. PV contractility was calculated using the equation: PV contraction = (PV Areamax - PV Areamin)/PV Areamax.

We did not find any significant (p>0.05) differences in the CT-derived PV contraction patterns between AF patients with or without recurrence of AF 3 months after WACA. When comparing PV contractility of the control group with patients after WACA we observed a significant (p<0.05) reduction in the contractility of the left and right superior PVs in patients after WACA regardless of procedural success.

Based on a sizable patient cohort, we cannot confirm PV contractility as a useful marker to predict short-term procedural success after WACA. Whether the differences between the control group and the WACA cohort are procedure-related or a general observation in patients with AF deserves further investigation.

In contrast to the results of several smaller prior MRI-based studies, PV contractility does not seem to serve as a valuable marker to predict AF recurrence after WACA. 

Ebersberger, U, Bernard, M, Schoepf, U, McQuiston, A, Wharton, J, Wince, W, Blanke, P, Wang, Y, Geyer, L, Silverman, J, Gray, J, Hoffmann, E, Cardiac CT in Atrial Fibrillation Ablation – Is Pulmonary Vein Contractility a Marker for Procedural Success?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011161.html