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AAPM 2025 - 67th Annual Meeting & Exhibition of the American Association of Physicists in Medicine

Delayed Enhancement-MRI Scanning Before Atrial Fibrosis Ablation Helps Predict Treatment Effectiveness

By MedImaging International staff writers
Posted on 10 Sep 2013

The use of delayed enhancement magnetic resonance imaging (DE-MRI) in patients with atrial fibrillation, performed before ablative treatment, can help assess the degree of injured heart tissue (atrial fibrosis) and predict whether treatment will be effective or not.

The recent findings were an outcome of the DE-MRI determinant of successful Catheter Ablation of Atrial Fibrillation (DECAAF) trial. “The DECAAF results show that stage of atrial fibrosis prior to ablation is a new, powerful, independent predictor of outcome,” said lead investigator Nasir Marrouche, MD, from the CARMA Center at the University of Utah (Salt Lake City, USA). “By performing this imaging before ablative treatment we can triage patients according to likelihood of treatment success, and avoid ablative procedures in those patients for whom it is unlikely to work. If a patient has late stage 3 or stage 4 fibrosis their chance of being cured is only 30%–35% which is really low, but if they’re in an early stage, their chance of cure is 60%–80%,” he said.

The DECAAF trial included 260 atrial fibrillation (AF) patients with atrial fibrosis who were in the process of undergoing ablation. The patients, from 15 centers in United States, Australia, and Europe were an average age of 59 years, and 64.6% of them conducted up to 30 days before ablation in all patients to determine the presence and extent of atrial fibrosis, whereas postablation DE-MRI was performed at 90-days follow-up in 177 of the study participants, to determine the extent of residual ablation. At the 90-day follow-up, recurrence of arrhythmia was observed in 88 of the 260 patients (33.8%), based on Holter monitors and electrocardiograms (ECGs).

Multivariate analysis showed two independent predictors of successful ablation or recurrent symptoms were stage of atrial fibrosis before ablation therapy (p < 0.001) as well as residual fibrosis after (p < 0.001). Patients whose preablation fibrosis was stage 1 (defined as less than 10% damaged atrial tissue) had an 85.8% success rate, those with stage 2 (10%–20% damage) had a 63.3% success rate, those with stage 3 (20%–30% damage) had a 55% success rate and those with stage 4 (more than 30% damage) had a 31% success rate.

For every increased percentage of fibrosis before ablation, there was 6.3% increased chance of recurrent symptoms after ablation (hazard ratio [HR] 1.063), according to Dr. Marrouche. Correspondingly, for every percentage of residual fibrosis there was an 8.2% increased risk of recurrent symptoms (HR 1.082).

Based on postablation imaging, a secondary finding of the study revealed that the kind of ablation clinicians used also had an impact on the rate of success. The choice of approach was not dictated in the study protocol and was left to the discretion of individual treating physicians.

After comparing preablation images of fibrotic tissue, with postablation images showing the extent of residual fibrosis, an unexpected finding was that pulmonary vein ablation, which is the standard-of-care in atrial fibrillation ablation candidates, is not the best ablative technique, according to Dr. Marrouche. “We do ablation around the pulmonary veins because we have assumed for years that the trigger for AF comes from the vein—that’s the standard of care,” he said. “But what we found in DECAAF is that ablation of the veins did not predict outcome. In fact, the most important predictor of outcome, along with stage of atrial fibrosis, was the degree of ablation of the fibrotic tissue. Rather than targeting the pulmonary veins, procedures which ablated fibrotic tissue produced better outcomes—the more that was targeted, the better the outcome.”

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CARMA Center at the University of Utah

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59 (!!!!! 1994.1329956055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

60 (104.90417480469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

61 (!!!!! 8003.9501190186): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

62 (853.7769317627): SELECT fid FROM jos_deeppockets WHERE id=294748154 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294748154 AND published='1' LIMIT 1

63 (318.05038452148): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

64 (960.11161804199): select jos_twitters.link from jos_twitters where cat=10

65 (89.883804321289): select jos_facebook.link from jos_facebook where cat=10

66 (33.140182495117): select jos_google_plus.link from jos_google_plus where cat=10

67 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

68 (257.96890258789): SELECT fid FROM jos_deeppockets WHERE id=294748154 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294748154 AND published='1' LIMIT 1

69 (34.093856811523): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

70 (499.01008605957): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748154 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (427.0076751709): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748154 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (47.922134399414): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (54.836273193359): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (61.03515625): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748154 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (38.14697265625): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748154 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (32.901763916016): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (276.08871459961): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (106.0962677002): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (!!!!! 2990.0074005127): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

105 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

106 (66.041946411133): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748154 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (61.03515625): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748154 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

109 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

110 (52.928924560547): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294748154 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (497.10273742676): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294748154 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (646.82960510254): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (498.05641174316): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

115 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

116 (59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

117 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

118 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

119 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

120 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

121 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

122 (283.95652770996): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 21759.033203125): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (476.83715820312): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748154 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748154 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 7735.013961792): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (100.85105895996): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (38.862228393555): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (29.087066650391): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (41.961669921875): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (279.90341186523): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (54.121017456055): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (28.133392333984): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (427.0076751709): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (308.99047851562): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (216.00723266602): SELECT name FROM jos_deeppockets WHERE id=212

138 (32.901763916016): SELECT name FROM jos_deeppockets WHERE id=212

139 (528.09715270996): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (459.90943908691): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

142 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

143 (!!!!! 8156.0611724854): TRUNCATE TABLE jos_trademed_module

144 (86.069107055664): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748154 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (54.121017456055): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748154 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (805.85479736328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

149 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

150 (!!!!! 1116.0373687744): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (54.121017456055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

152 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

153 (47.922134399414): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748154 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748154 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (372.88665771484): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

155 (40.054321289062): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

156 (30.994415283203): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (759.12475585938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

158 (45.7763671875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748154 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748154 AND published='1' LIMIT 1

159 (35.04753112793): select jos_twitters.link from jos_twitters where cat=10

160 (32.186508178711): select jos_facebook.link from jos_facebook where cat=10

161 (32.186508178711): select jos_google_plus.link from jos_google_plus where cat=10

162 (30.994415283203): select jos_linkedin.link from jos_linkedin where cat=10

163 (234.12704467773): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (877.14195251465): insert into jos_banners_delta values (14615,'2025-06-25 00:12:11','216.73.216.120','view'),(14202,'2025-06-25 00:12:11','216.73.216.120','view'),(14203,'2025-06-25 00:12:11','216.73.216.120','view')

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