Related Experiment Video
Updated: Apr 30, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Atrial structure and function 5 years after successful ablation for persistent atrial fibrillation: an MRI study
Hubert Cochet1, Daniel Scherr, Stephan Zellerhoff
1Department of Cardiovascular Imaging, CHU / Université de Bordeaux, Pessac, France; L'Institut de Rythmologie et de Modélisation Cardiaque LIRYC, CHU / Université de Bordeaux / INSERM U1045, Pessac, France.
Years after successful persistent atrial fibrillation (PsAF) ablation, atrial structure and function are significantly impaired. Left atrial (LA) dysfunction, including reduced contractility and compliance, is closely linked to the extent of atrial scar burden.
Area of Science:
- Cardiology
- Medical Imaging
- Electrophysiology
Background:
- The long-term atrial structural and functional consequences following ablation for persistent atrial fibrillation (PsAF) remain incompletely understood.
- Successful ablation aims to restore normal sinus rhythm, but the impact on atrial tissue integrity over time is a critical area of investigation.
Purpose of the Study:
- To quantitatively assess atrial structure and function, specifically focusing on scar burden and mechanical properties, years after successful PsAF ablation.
- To explore the relationship between atrial scar extent and functional parameters, as well as exercise capacity, in patients treated for PsAF.
Main Methods:
- Utilized delayed-enhanced and velocity-encoded MRI to quantify atrial scar burden and outflows in 26 patients (mean follow-up 80 months).
- Assessed atrial conduit function (CF), active emptying fraction (AEF), expansion index (EI), and inter-appendage mechanical activation delay using cine imaging.
- Correlated MRI-derived scar burden and functional parameters with baseline and follow-up exercise testing data.
Main Results:
- Significant left atrial (LA) and right atrial (RA) scar burden were observed (29% and 4.3%, respectively).
- LA active emptying fraction (AEF) and expansion index (EI) were markedly reduced (10.0% and values not provided, respectively), with significant inter-appendage mechanical delay (83 ms).
- LA scar extent was strongly associated with reduced LA AEF, LA EI, A-wave peak, and increased mechanical delay, and correlated with diminished exercise capacity.
Conclusions:
- Atrial contractility and compliance are substantially impaired years after successful PsAF ablation.
- The degree of left atrial dysfunction is closely related to the extent of scar burden in the atria.
- These findings highlight the persistent structural remodeling and functional deficits that can occur post-ablation for PsAF.
