Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Cardiology Research Institute, Tomsk NRMC, Tomsk, Russian Federation.
E. Meshalkin National Medical Research Center Ministry of Health of the Russian Federation, Novosibirsk, Russian Federation.
J Nucl Cardiol. 2022 Oct;29(5):2220-2231. doi: 10.1007/s12350-021-02658-y. Epub 2021 May 27.
Previous studies show inconsistent results on the role of innervation imaging (with I-mIBG) in predicting late atrial fibrillation (AF) recurrence after catheter ablation (CA). These studies included patients with paroxysmal AF and studied prognostic value of post-CA I-123-mIBG parameters. Current study investigated the ability of pre CA 123-I-mIBG imaging to predict late AF recurrence in patients with persistent AF.
I-mIBG cardiac imaging was performed before CA in 82 patients with persistent AF. Patient was followed for 12 months.
Multivariable analysis demonstrated that late heart-to-mediastinum ratio (H/M) and washout rate (WR) were independent predictors of AF recurrence. ROC-curve analysis data showed that H/M <1.6 (sensitivity 73.53%, specificity 81.3%, AUC 0.792, P < .001) and WR > 25.11 (sensitivity 70.6%, specificity 70.8.3%, AUC 0.712, P < .001) indicate high probability of AF relapses during 12 months after CA.
Pre-CA parameters of global cardiac sympathetic activity estimated by I-mIBG scintigraphy are associated with late AF relapses in persistent AF patients with normal LVEF and absence of significant CAD.
先前的研究表明，神经支配成像（使用 I-mIBG）在预测导管消融（CA）后晚期心房颤动（AF）复发中的作用结果不一致。这些研究包括阵发性 AF 患者，并研究了 CA 后 I-123-mIBG 参数的预后价值。目前的研究调查了 CA 前 123-I-mIBG 成像预测持续性 AF 患者晚期 AF 复发的能力。
对 82 例持续性 AF 患者在 CA 前进行 I-mIBG 心脏成像。对患者进行了 12 个月的随访。
多变量分析表明，晚期心脏与纵隔比值（H/M）和洗脱率（WR）是 AF 复发的独立预测因素。ROC 曲线分析数据显示，H/M<1.6（敏感性 73.53%，特异性 81.3%，AUC 0.792，P<.001）和 WR>25.11（敏感性 70.6%，特异性 70.8.3%，AUC 0.712，P<.001）提示 CA 后 12 个月内 AF 复发的可能性较高。
I-mIBG 闪烁显像术估计的心脏交感神经活动的 CA 前参数与 LVEF 正常且无明显 CAD 的持续性 AF 患者的晚期 AF 复发有关。
