Imperial College London
Alternate

Emeritus ProfessorRichardUnderwood

Faculty of Medicine, National Heart & Lung Institute

Emeritus Professor of Cardiac Imaging
 
 
 
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Contact

 

+44 (0)20 7351 8811srunderwood

 
 
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Location

 

2.30Britten WingRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Stirrup:2020:10.1007/s12350-018-01535-5,
author = {Stirrup, J and Gregg, S and Baavour, R and Roth, N and Breault, C and Agostini, D and Ernst, S and Underwood, SR},
doi = {10.1007/s12350-018-01535-5},
journal = {Journal of Nuclear Cardiology},
pages = {1939--1950},
title = {Hybrid solid-state SPECT/CT left atrial innervation imaging for identification of left atrial ganglionated plexi: Technique and validation in patients with atrial fibrillation},
url = {http://dx.doi.org/10.1007/s12350-018-01535-5},
volume = {27},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Ablating left atrial (LA) ganglionated plexi (GP), identified invasively by high-frequency stimulation (HFS) during pulmonary vein isolation (PVI), may reduce atrial fibrillation (AF) recurrence. 123I-metaiodobenzylguanidine (123I-mIBG) solid-state SPECT LA innervation imaging (LAII) has the spatial resolution to detect LAGP non-invasively but this has never been demonstrated in clinical practice. METHODS: 20 prospective patients with paroxysmal AF scheduled for PVI underwent 123I-mIBG LAII. High-resolution tomograms, reconstructed where possible using cardiorespiratory gating, were co-registered with pre-PVI cardiac CT. Location and reader confidence (1 [low] to 3 [high]) in discrete 123I-mIBG LA uptake areas (DUAs) were recorded and correlated with HFS. RESULTS: A total of 73 DUAs were identified, of which 59 (81%) were HFS positive (HFS +). HFS + likelihood increased with reader confidence (92% [score 3]). 64% of HFS-negative DUAs occurred over the lateral and inferior LA. Cardiorespiratory gating reduced the number of DUAs per patient (4 vs 7, P = .001) but improved: HFS + predictive value (76% vs 49%); reader confidence (2 vs 1, P = .02); and inter-observer, intra-observer, and inter-study agreement (κ = 0.84 vs 0.68; 0.82 vs 0.74; 0.64 vs 0.53 respectively). CONCLUSIONS: 123I-mIBG SPECT/CT LAII accurately and reproducibly identifies GPs verified by HFS, particularly when reconstructed with cardiorespiratory gating.
AU  - Stirrup,J
AU  - Gregg,S
AU  - Baavour,R
AU  - Roth,N
AU  - Breault,C
AU  - Agostini,D
AU  - Ernst,S
AU  - Underwood,SR
DO  - 10.1007/s12350-018-01535-5
EP  - 1950
PY  - 2020///
SN  - 1071-3581
SP  - 1939
TI  - Hybrid solid-state SPECT/CT left atrial innervation imaging for identification of left atrial ganglionated plexi: Technique and validation in patients with atrial fibrillation
T2  - Journal of Nuclear Cardiology
UR  - http://dx.doi.org/10.1007/s12350-018-01535-5
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30694425
UR  - http://hdl.handle.net/10044/1/70294
VL  - 27
ER  -
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