Table 4

Available Literature on LGE Fibrosis Imaging

First Author (Ref. #)YearType of StudyAblationNEnrollmentPrimary Result
Oakes et al. (75)2009Single centerYes8112/2006–01/2008LGE MRI is able to assess pre-ablation LA fibrosis
Peters et al. (76)2009Yes3504/2005–05/2007Recurrence of AF correlates with post-procedural LGE
Kuppahally et al. (38)2010Single centerYes68Echocardiographic LA reverse remodeling after catheter is predicted by pre-ablation delayed enhancement of LA by MRI
Kuppahally et al. (77)2010Single centerNo6506/2006–3/2008LA wall fibrosis by DE-MRI is inversely related to LA strain and strain rate
Mahnkopf et al. (37)2010Single centerNo33312/2006–11/2009The degree of LA structural remodeling as detected using DE-MRI is independent of AF type and associated comorbidities
Akoum et al. (40)2011Single centerYes14411/2006–11/2008Overall post-ablation LA wall scarring predicts recurrence in moderate fibrosis stages
Daccarett et al. (46)2011MulticenterNo387LA fibrosis is associated with a history of stroke
McGann et al. (78)2011Single centerYes3707/2009–01/2010No-reflow areas in LGE MRI after ablation predict chronic scar formation
Akoum et al. (9)2012Single centerNo34411/2006–11/2009Significant atrial fibrosis is associated with sinus node dysfunction
Akoum et al. (12)2013Single centerNo17804/2009–09/2010Atrial fibrosis is associated with LAA thrombi and spontaneous echo contrast
Akkaya et al. (62)2013Single centerYes38407/2007/–3/2010Amount of structural remodeling in AF patients depending on LV systolic dysfunction
Malcolme-Lawes et al. (16)2013MulticenterYes50LA scar quantified automatically correlates with colocated endocardial voltage
Bisbal et al. (19)2014Single centerNo1506/2012–03/2013DE-CMR can identify and localize gaps after PVI
Harrison et al. (10)2014Animal studyYes16Histopathological validation of CMR and endocardial voltage mapping to define acute and chronic atrial ablation injury
McGann et al. (15)2014Single centerYes42612/2006–05/2009LA remodeling, measured by LGE-MRI, predicts outcome of AF catheter ablation
Marrouche et al. (14)2014MulticenterYes32908/2010–08/2011Pre-ablation LA fibrosis predicts outcome after catheter ablation of AF (DECAAF trial)
Parmar et al. (79)2014Single centerYes7008/2011–12/2012Electroanatomic mapping overestimates scar assessed by LGE-MRI after AF ablation
Akoum et al. (80)2015MulticenterYes17708/2010–08/2011LGE-MRI of ablation-induced scarring demonstrates that chronic PV encirclement is rarely achieved
Fukumoto et al. (18)2015Single centerYes2004/2010–04/2013Intensity of LGE can differentiate between ablation-induced and pre-existing atrial scarring
Chrispin et al. (81)2016Single centerYes9AF rotor incidence is not correlated to global or regional extent of atrial LGE
Khurram et al. (82)2016Single centerYes16511/2011–12/2013LGE >35% predicts early AF recurrence
Chrispin et al. (11)2017Single centerNo179The presence of pre-ablation LA LGE extent was associated with increasing LA volume

AF = atrial fibrillation; CMR = cardiac magnetic resonance; DE = delayed enhancement; LA = left atrial/atrium; LAA = left atrial appendage; LV = left ventricular; PV = pulmonary vein; PVI = pulmonary vein isolation; other abbreviations as in Table 2.