EXercise Cardiac Magnetic Resonance Assessment of Left Atrial Mechanics Following Ablation TO Reduce Atrial Fibrillation Burden and Correlation with Exercise CapacitY: EXCLAMATORY Longitudinal Study

项目总结 房颤是一种非常普遍的疾病，会导致心房无序收缩(顶室 心脏)。每四个人中就有一个人会在一生中受到影响。众所周知，心律失常有一种 与功能障碍的心房收缩的双向关系，这种情况本身正变得越来越清楚 作为一种个人可能发展为心力衰竭的手段。然而，大多数出版的文学作品都是 DATE包括检查仰卧休息时的心房功能，因此不完全描述变化的 一个人在日常生活活动中所经历的劳作状态。基于运动的心血管磁化 磁共振成像是一种强大的非侵入性诊断手段，可以在 并有可能揭示房颤患者可能通过哪些关键机制 显性心力衰竭的进展--以及目前的治疗技术(即导管消融术)是否可能 改变这一轨迹。 此应用程序的主要目标是促进首席研究员、医学博士Cory Trankle的培训 作为一名以患者为中心的独立研究人员，使用基于运动的诊断方法(包括 磁共振成像)，特别感兴趣的是描述运动限制的机制 例如左房功能不全，并将其确定为潜在生物标志物和治疗靶点 干预措施。除了授课课程和分专业研讨会外，Trankle博士还将领导一个 多学科小组进行了一项前瞻性临床研究，调查导管消融术对 运动过程中心房颤动对心房功能有影响。他将针对房颤患者的三个具体目标发表演讲。 接受导管消融治疗的房颤：(1)确定消融对左心房收缩功能的影响 在运动中增强其功能，(2)确定消融对运动期间左心功能的影响 运动，以及(3)确定在左心室性能中经历的那些变化是否真的 与左房功能改变有关。更好地了解导管消融的影响，a 对房颤的常见治疗，在运动期间对这些心脏结构具有潜在的 确定心力衰竭发病率最高的人群，并在这一高度集中的情况下进行更有针对性的治疗 流行的疾病。

PROJECT SUMMARY Atrial fibrillation is a highly prevalent condition resulting in disordered contraction of the atria (top chambers of the heart). It affects one in four individuals during their lifetime. It is known that the arrhythmia has a bidirectional relationship with dysfunctional atrial contraction, a condition which itself is becoming understood as a means by which individuals may develop heart failure. However, the majority of published literature to date involves examining atrial function while lying supine at rest, thus incompletely characterizing the varying states of exertion that one experiences during activities of daily living. Exercise-based cardiovascular magnetic resonance imaging is a powerful non-invasive diagnostic modality that can measure heart function during exercise and has the potential to uncover key mechanisms by which patients with atrial fibrillation may progress to overt heart failure – and whether current treatment techniques (namely, catheter ablation) may alter that trajectory. The broad goal of this application is to facilitate training of the principal investigator, Dr. Cory Trankle, MD, for a career as a patient-centered independent researcher who uses exercise-based diagnostic modalities (including magnetic resonance imaging), with a specific interest in characterizing mechanisms of exercise limitations such as left atrial dysfunction and identifying them as potential biomarkers and targets for therapeutic interventions. In addition to didactic coursework and subspecialty seminars, Dr. Trankle will lead a multidisciplinary team conducting a prospective clinical study investigating the effects that catheter ablation for atrial fibrillation has on atrial function during exercise. He will address three specific aims in patients with atrial fibrillation undergoing catheter ablation: (1) determine the effects of ablation on the ability of the left atrium to augment its function during exercise, (2) determine the impacts ablation on left ventricular performance during exercise, and (3) determine whether those changes experienced in left ventricular performance are indeed associated with changes in left atrial function. A better understanding of the impact of catheter ablation, a common treatment for atrial fibrillation, has on these cardiac structures during exercise has the potential to identify those at highest risk for heart failure incidence and lead to more targeted treatment in this highly prevalent disease.