Quantification of atrial cardiomyopathy disease severity by electroanatomic voltage mapping and cardiac magnetic resonance imaging

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main source(s): The authors acknowledge the support British Heart Foundation Centre for Research Excellence Award III (RE/18/5/34216). SEW is supported by (FS/20/26/34952). Background Atrial late gadolinium enhancement (Atrial-LGE) and electroanatomic voltage mapping (Atrial-EAVM) quantify anatomical functional extent atrial cardiomyopathy. Prior studies provide conflicting information relating to level agreement between these modalities assessment cardiomyopathy disease severity. Purpose We aimed explore relationships between, outcomes from, contrasting measures severity in patients with fibrillation undergoing ablation. Methods Atrial-LGE Atrial-EAVM was performed first-time ablation fibrillation. severities were quantified using CEMRGApp OpenEP[1] Atrial-EAVM, respectively. Correlations modalities, their clinical features arrhythmia recurrence assessed. Results quantification In 123 (60±10 years, paroxysmal (n=58), persistent (n=65)) (Figure 1, panel A). moderately correlated (r=0.41, P<0.001), a mean fibrosis burden 32.4±21.8% B). strength correlation dependent on thresholds chosen define abnormal tissue. yielding strongest IIR >0.97 (for Atrial-LGE) <1.17 mV Atrial-EAVM). Using thresholds, amongst highest tertile (mean differences 5.9% (95% CI -30.4% 42%)). Fibrosis greater than (46.4±7.48% versus 13.7±7.13%, P<0.005) lowest C). These younger, had smaller atria frequency higher tertiles 2). both (39.3±23.1% 28.5±20.2%, P=0.010) (58.69±11.60 53.33±9.63, P=0.011). multivariable analysis, (OR 1.04 1.00-1.09), P=0.037) independently associated recurrence. Conclusions demonstrate first time that consequences are most evident disease. This explains variations prior will inform future applications techniques.