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Cardiac 123I-mIBG scintigraphy for prediction of catheter ablation outcome in patients with atrial fibrillation

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Previous studies show inconsistent results on the role of innervation imaging (with 123I-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.

Methods

123I-mIBG cardiac imaging was performed before CA in 82 patients with persistent AF. Patient was followed for 12 months.

Results

Multivariable analysis demonstrated that late heart-to-mediastinum ratio (H/Mlate) and washout rate (WR) were independent predictors of AF recurrence. ROC-curve analysis data showed that H/Mlate <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.

Conclusion

Pre-CA parameters of global cardiac sympathetic activity estimated by 123I-mIBG scintigraphy are associated with late AF relapses in persistent AF patients with normal LVEF and absence of significant CAD.

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Abbreviations

af:

Atrial fibrillation

CA:

Catheter ablation

123I-mIBG:

Iodine-123 metaiodobenzylguanidine

HF:

Heart failure

PVI:

Pulmonary vein isolation

H/M:

Heart-to-mediastinum ratio

WR:

Washout rate

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Funding

This work is partly supported by Russian Science Foundation, Grant No. 17-75-20118.

Disclosures

J.V. Varlamova declares that she has no conflict of interest. Author S.I. Sazonova declares that she has no conflict of interest. Author N.A. Nikitin declares that his work was supported by Russian Science Foundation, Grant No. 17-75-20118. Author S.M.Minin declares that that his work was supported by Russian Science Foundation, Grant No. 17-75-20118. Author I.V. Kisteneva declares that she has no conflict of interest. Author R.E. Batalov declares that he has no conflict of interest. Author A.I .Mishkina declares that she has no conflict of interest Author Y.N.Ilushenkova declares that she has no conflict of interest. Author K.V.Zavadovsky declares that he has no conflict of interest. Author S.V. Popov declares that he has no conflict of interest. Author A.B. Romanov declares that his work was supported by Russian Science Foundation, Grant No. 17-75-20118.

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Authors and Affiliations

  1. Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences, Cardiology Research Institute, Tomsk NRMC, Tomsk, Russian Federation

    S. I. Sazonova MD, PhD, J. V. Varlamova MD, PhD, I. V. Kisteneva MD, PhD, R. E. Batalov MD, PhD, A. I. Mishkina MD, PhD, Y. N. Ilushenkova MD, PhD, K. V. Zavadovsky MD, PhD & S. V. Popov MD, PhD

  2. E. Meshalkin National Medical Research Center Ministry of Health of the Russian Federation, Novosibirsk, Russian Federation

    N. A. Nikitin MD, S. M. Minin MD, PhD & A. B. Romanov MD, PhD

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  1. S. I. Sazonova MD, PhD
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Correspondence to S. I. Sazonova MD, PhD.

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Sazonova, S.I., Varlamova, J.V., Nikitin, N.A. et al. Cardiac 123I-mIBG scintigraphy for prediction of catheter ablation outcome in patients with atrial fibrillation. J. Nucl. Cardiol. 29, 2220–2231 (2022). https://doi.org/10.1007/s12350-021-02658-y

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