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Atrial The treatment of atrial fibrillation (AF) includes 2 axes: the prevention of the cardio-embolic risk and rhythm control. The possibilities for this control are antiarrhythmic drugs and, above all, catheter ablation, an interventional cardiology technique which consists in treating the areas responsible for the initiation and perpetuation of AF by applying radiofrequency energy or cryotherapy to the myocardial tissue.
Limited research has been done on the combination of different parameters to manage AF, especially during the initial stage of the disease. A translational and multimodal approach could make it possible to better characterize this pathology and thus, help to adjust the therapeutic management for the patients.
The combined analysis of regional electrophysiological, morphological, and functional parameters of the left atrium could make it possible to better detect early atrial cardiomyopathy and predict recurrences of atrial fibrillation.
The electrophysiological substrate for patients with persistent atrial fibrillation is heterogeneous with areas of atrial myocardium of low voltage amplitudes and areas of rapid fragmented signals in arrhythmia. The targets of ablation treatment in these cases are currently poorly defined. Several promising strategies have emerged, such as the isolation of fibrotic areas, low voltage.
An integration analysis of regional electrophysiological, morphological, and functional parameters of the left atrium, therefore, open up a new area of research that has not been studied to date and could help to better guide the therapeutic management of patients with AF.
The study aims to assess the association between regional and global myocardial strain abnormalities on magnetic resonance imaging (MRI) and the amplitude of the atrial intracardiac electrical potential, in young subjects with symptomatic AF.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with diagnosed Atrial fibrillation and an indication of catheter ablation | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MRI (with injection of contrast product) | Diagnostic Test | All patients included in the study will undergo two MRI examinations (with injection of contrast product) before and after the ablation procedure. |
| Measure | Description | Time Frame |
|---|---|---|
| Correlation between the regional and global longitudinal strain peaks (percent (%)) and voltage (millivoltage(mV)) of the left atrium measured by MRI and catheter ablation | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Localization in the left atrium and area of low amplitude electrogram areas (<0.5 mV, <0.3 mV and <0.1 mV) measured during the ablation procedure | 1 month | |
| Localization in the left atrium and areas of fragmented atrial complexes measured during the ablation procedure |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Nicolas BADENCO, MD | Contact | +33 1 42 16 29 76 | nicolas.badenco@aphp.fr | |
| Zohra ABBOU | Contact | 01 42 16 16 25 | +33 | zohra.abbou@aphp.fr |
| Name | Affiliation | Role |
|---|---|---|
| Nicolas BADENCO, MD | Assistance Publique - Hôpitaux de Paris | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institut de Cardiologie de la Pitié-Salpêtrière | Paris | 75013 | France |
Data are available upon reasonable request. The procedures carried out with the French data privacy authority (CNIL, Commission Nationale de l'Informatique et des Libertés) do not provide for the transmission of the database, nor do the information and consent documents signed by the patients.
Consultation by the editorial board or interested researchers of individual participant data that underlie the results reported in the article after deidentification may nevertheless be considered, subject to prior determination of the terms and conditions of such consultation and in respect for compliance with the applicable regulations.
Beginning 3 months and ending 3 years following article publication. Requests out of these time frame can also be submitted to the sponsor
Researchers who provide a methodologically sound proposal
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| 1 months |
| Local atrial impedance measured by ablation catheter | 1 months |
| Contact force measured by ablation catheter | 1 month |
| Local impedance drop measured during radiofrequency delivery | 1 month |
| Duration of the ablation for each radiofrequency delivery | 1 month |
| Localization of the segmental and regional alteration of the myocardium in the left atrium measured during MRI | 3 months |
| Localization of zones with impaired 4D flow in the left atrium measured during MRI | 3 months |
| Left atrium volume (milliliter (mL)) measured during MRI | 3 months |
| Localization of areas of late enhancement in the left atrium | 3 months |
| Lesion transmurality performed by ablation in each segment of the pulmonary veins | 3 months |
| Subcutaneous measurement (AGE Reader) which combines aging and accumulation of glycated proteins in the subcutaneous tissue measured during MRI | 3 months |
| Volumes (milliliter (ml)) of the left atrium: in the basal state and after passive filling measured during echocardiography | 1 month |
| Analysis of the longitudinal deformation (strain) in speckle tracking in the basal state and after passive measured during echocardiography | 1 month |
| Absence of atrial fibrillation occurrence | 12 months |
| Absence of persistent atrial fibrillation occurrence | 12 months |
| Absence of atrial tachycardia or atrial flutter occurrence after catheter ablation | 12 months |
| Absence of palpitation occurrence after catheter ablation | 12 months |
| 6-minute walking test to assess exercise capacity | 1 month |
| Differences in the volumes (milliliter (ml)) of the left atrium (maximum, minimum, atrial pre-systole) between the segmentation performed manually and the segmentation obtained by learning transfer | 3 months |
| Distance between areas of low voltages identified by the cartography and areas of late 3D enhancement identified by MRI, measurement based on the volume (milliliter (ml)) resulting from CT-scan and MRI fusion | 3 months |
| ID | Term |
|---|---|
| D001281 | Atrial Fibrillation |
| ID | Term |
|---|---|
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D008279 | Magnetic Resonance Imaging |
| ID | Term |
|---|---|
| D014054 | Tomography |
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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