Predicting Atrial Fibrillation Based on Atrial Fibrosis

In a recent meta-analysis published in Current Cardiology Reviews, researchers explored whether stages of fibrosis observed on late gadolinium enhancement magnetic resonance imaging (LGE-MRI) could predict atrial fibrillation recurrence after catheter ablation.

According to the study’s lead author, Manjari Rani Regmi, there was a strong association between left atrial fibrosis on LGE-MRI and atrial fibrillation recurrence post-catheter ablation. The authors’ systematic literature review identified 9 studies containing 1787 patients who underwent LGE-MRI to evaluate atrial fibrosis prior to undergoing catheter ablation for atrial fibrillation.

Atrial Fibrosis Predicts Atrial Fibrillation Recurrence After Ablation

The study’s primary comparisons included stage IV atrial fibrosis versus stage I, combined stages III and IV versus stages I and II, and stage IV versus combined stages I, II, and III. The authors used random-effects models to calculated pooled odds ratios (ORs) using the DerSimonian and Laird method.

Researchers found patients with stage IV atrial fibrosis after ablation had a higher rate of atrial fibrillation recurrence compared with those with stage I atrial fibrosis (OR, 9.54; 95% CI, 3.81-28.89; P<.00001).

In addition, the investigators noted patients with combined stages III and IV atrial fibrosis demonstrated significantly higher atrial fibrillation recurrence than patients with combined stages I and II (OR, 2.37; 95% CI, 1.61-3.50; P<.00001). Likewise, patients with stage IV atrial fibrosis had a higher rate of recurrence post-ablation compared with combined stages I, II, and III patients (OR, 4.24; 95% CI, 2.39-7.52; P<.001).

Overall, Regmi and colleagues took their findings to support a strong association between degree of left atrial fibrosis observed on LGE-MRI and recurrence of atrial fibrillation after catheter ablation.

“The finding of this study will further assist clinicians in predicting the recurrence rate of AF based on the amount of fibrosis and tailor therapeutic decisions for further management,” the authors ended.

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