Quantitative analysis of left atrial fibrosis in atrial fibrillation patients using 3D Late Gadolinium-enhanced Cardiac MRI

Motivation: Atrial fibrillation (AF) is associated with left atrial remodeling, particularly through fibrosis. Goal(s): To quantitatively analyze left atrial fibrosis distribution in AF patients and investigate differences between paroxysmal and persistent types of AF. Approach: Using three-dimensional late gadolinium enhancement cardiac magnetic resonance, we assessed left atrial fibrosis distribution in AF patients. Multivariate analysis was performed to evaluate regional fibrosis as a risk factor for persistent AF. Results: Fibrosis was concentrated in posterior wall and basal regions; fibrosis extent and severity were greater in persistent AF than in paroxysmal AF. Posterior wall fibrosis constituted a risk factor for persistent AF. Impact: Three-dimensional late gadolinium enhancement cardiac magnetic resonance quantification of left atrial fibrosis distribution in AF patients provides insights into fibrosis patterns. Fibrosis in posterior wall zone 3 is a risk factor for persistent AF and potential target for personalized therapies.