Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Mapping & Imaging D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-173 - Multimodality Imaging Of Atrial Remodeling And Risk Of Atrial Fibrillation In Patients With Cardiac Sarcoidosis (ID 480)


Background: Ventricular involvement in cardiac sarcoidosis (CS) patients is associated with adverse outcomes secondary to ventricular arrhythmias, and heart failure. However, atrial involvement and associated atrial remodeling as risk factors for atrial fibrillation (AF) has not been well studied
Objective: To examine imaging correlates of prevalent AF in CS patients by assessing atrial remodeling using CMR and PET scan.
Methods: Patients with probable or definite CS who undergone both CMR and PET were included. Prevalent AF was studied by reviewing medical records, ECGs, continuous rhythm monitoring records, and interrogation of implanted devices. Left atrial volumes, strain, and passive, active and total emptying fractions (LAEF) were measured in sinus rhythm using feature-tracking CMR. Atrial fluorodeoxyglucose (FDG) uptake was assessed both qualitatively (positive/negative) and quantitatively using maximum standardized uptake value (SUVmax).
Results: 51 patients (mean age: 52 ± 10 years, 58% male) were enrolled of whom 12 (23.5%) had AF. AF patients had higher minimum LA volume, lower passive, active, total, LAEF and atrial strain compared to those with no AF. No associations were found between SUVmax and AF, however, out of 5 patients with atrial FDG uptake on PET scan, 4 had AF. In multivariable analysis adjusted for age, sex, hypertension, heart failure, and diabetes, total LAEF (OR: 0.32; 95%CI: 0.12-0.86, P=0.024) and qualitative atrial FDG uptake (OR:25.7; 95%CI: 1.5-441.1, P=0.025) were independently associated with AF.
Conclusion: AF is frequent in CS patients. Assessment of LA structure and function using cardiac PET and CMR may help to identify those at risk for AF.