Arrhythmias & electrophysiologySecondary analysis
Effect of fibrosis regionality on atrial fibrillation recurrence: insights from DECAAF II
- Secondary analysis of the DECAAF II randomised trial
- post hoc analysis
Authors' conclusion
We have confirmed that atrial cardiomyopathy and remodelling are not a homogenous process, with variations in different regions of the LA. Atrial fibrosis does not uniformly affect the LA, and the left PV antral region has more fibrosis than the rest of the wall. Furthermore, we identified regional fibrosis of the LAA as a significant predictor of AF recurrence post-ablation in patients receiving MRI-guided fibrosis ablation in addition to standard PVI.
Study context
- Population
- Patients with persistent atrial fibrillation (AF) undergoing first-time catheter ablation with late gadolinium enhancement magnetic resonance imaging (LGE-MRI) within 1 month before ablation
- Participants
- 734 patients
- Comparison
- MRI-guided fibrosis ablation + pulmonary vein isolation (PVI) vs PVI only
Primary result
Regional fibrosis percentage and AF recurrence
Odds ratio
1.017
P = 0.021
As reported in the abstract
Further findings
Regional fibrosis percentage by left atrium (LA) region
- Left pulmonary vein (PV) antrum
- 29.30 ± 14.04%
- Lateral wall
- 23.23 ± 13.56%
- Posterior wall
- 19.80 ± 10.85%
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Summarised from the published abstract; every number is checked against it