Magnetic Resonance Imaging with Delayed Contrast Enhancement in Atrial Fibrillation: First Advances and Perspectives

Current paper reviews new opportunities in none invasive evaluation of the left atrial fibrosis in atrial fibrillation using late gadolinium enhancement magnetic resonance imaging. The first use of this technology in clinical practice is discussed. In a group of prospective studies it has been shown that structural atrial remodeling can influence the clinical course of atrial fibrillation and the efficiency of arrhythmia treatment. Several groups of national and European experts in morphology and MRI studies in a consensus suggest introduction of a new term fibrous atrial cardiomyopathy or fibrous cardiomyopathy of atrii, representing the structural and functional pathology of atrii, of clinical value in atrial fibrillation. These data make evidence for possibly wide noninvasive MRI studies of cardiovascular out-patients in order to make obvious the structure of atrial myocardium and atrial anatomy as a whole. Progress in MRI technologies of heart studies provides the possibility of imaging of thin atrial myocardium both in patients with primarily documented atrial fibrillation and in persons after interventional treatment of the arrhythmia. There are reasons to expect that LGE MRI data regarding atrial structure in atrial fibrillation are in a position to provide in a nearest future the improvement of management of such patients.