Cardiac magnetic resonance imaging-derived atrial fibrosis in patients with pre-atrial fibrillation.

Wahab, A.; Nadarajah, R.; Tomoaia, R.; Javed, W.; Reynolds, C.; Bennet, S.; Bhatty, A.; Lip, GYH.; Camm, J.; Wu, J.; Plein, S.; Swoboda, P.; Gale, CP.

Cardiac magnetic resonance imaging-derived atrial fibrosis in patients with pre-atrial fibrillation.

All Authors

Wahab, A.

Nadarajah, R.

Tomoaia, R.

Javed, W.

Reynolds, C.

Bennet, S.

Bhatty, A.

Lip, GYH.

Camm, J.

Wu, J.

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LTHT Author

Wahab, Ali
Nadarajah, Ramesh
Gale, Christopher

LTHT Department

Cardio-Respiratory
Cardiology

Publication Date

2025

Item Type

Journal Article

Abstract

INTRODUCTION: Atrial fibrosis identified on cardiac magnetic resonance (CMR) imaging has been proposed as a preprocedural imaging biomarker for patient selection for rhythm control interventions in patients with atrial fibrillation (AF). Whether atrial fibrosis is present in patients considered as 'pre-AF' is unknown. METHODS AND RESULTS: We prospectively recruited 12 participants with pre-AF as defined by the Future Innovations in Novel Detection for Atrial Fibrillation (FIND-AF machine learning algorithm, without AF diagnosed during AF screening, and compared them to 25 participants with confirmed AF. All participants underwent CMR using a 3T system with left atrial fibrosis quantification and ADAS-3D left atrial image postprocessing software. Participants with pre-AF had smaller left atrial end-systolic (33.6+/-9.8 vs 43.0+/-17.0, p=0.003) and end-diastolic (16.5+/-8.7 vs 28.2+/-14.4, p=0.007) volumes, and higher left atrial ejection fraction (59.6+/-14.6 vs 40.7+/-17.5, p=0.005) than participants with AF. The extent of atrial fibrosis was not different between those with pre-AF and AF (borderzone (%) 5.2+/-5.0 vs 2.9+/-6.9, p=0.772; borderzone fibrosis (cm) 6.2+/-5.8 vs 6.8+/-10.7, p=0.927). CONCLUSION: CMR identifies atrial fibrosis before manifest AF in patients with pre-AF as defined by a machine learning algorithm.