The Role of Cardiac Magnetic Resonance in Characterizing Atrial Cardiomyopathy and Guiding Substrate Ablation in Atrial Fibrillation: A Narrative Review
Cardiac magnetic resonance imaging (MRI) is increasingly recognized as a promising tool for tissue characterization in atrial fibrillation (AF), providing detailed insights into anatomy, fibrosis, and scarring. While MRI cannot directly guide ablation lesions, its ability to identify arrhythmogenic...
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MDPI AG
2025-03-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/12/4/114 |
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| author | Jean Pierre Jabbour Marta Palombi Michela Bonanni Andrea Matteucci Luca Arcari Nicola Pierucci Vincenzo Mirco La Fazia Carlo Lavalle Marco Valerio Mariani |
| author_facet | Jean Pierre Jabbour Marta Palombi Michela Bonanni Andrea Matteucci Luca Arcari Nicola Pierucci Vincenzo Mirco La Fazia Carlo Lavalle Marco Valerio Mariani |
| author_sort | Jean Pierre Jabbour |
| collection | DOAJ |
| description | Cardiac magnetic resonance imaging (MRI) is increasingly recognized as a promising tool for tissue characterization in atrial fibrillation (AF), providing detailed insights into anatomy, fibrosis, and scarring. While MRI cannot directly guide ablation lesions, its ability to identify arrhythmogenic substrates could improve patient stratification and procedural planning. Despite these theoretical advantages, the clinical utility of MRI in guiding substrate-based ablation strategies remains a matter of debate. Methods: Our review evaluates the current evidence supporting the integration of MRI into the workflow of AF ablation. Specifically, we examine findings from randomized trials and prospective studies that have investigated the predictive value of MRI-derived fibrosis quantification for procedural outcomes and arrhythmia recurrence. We aim to assess whether MRI can enhance the personalization of ablation strategies and predict treatment success. Challenges such as variability in imaging protocols, lack of standardization in fibrosis quantification, and limited large-scale validation are also addressed. This review provides a comprehensive overview of the current status and potential of MRI in the evolving field of AF ablation. |
| format | Article |
| id | doaj-art-2c137a22d76545a4bfc551d333d9e710 |
| institution | DOAJ |
| issn | 2308-3425 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-2c137a22d76545a4bfc551d333d9e7102025-08-20T03:13:49ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-03-0112411410.3390/jcdd12040114The Role of Cardiac Magnetic Resonance in Characterizing Atrial Cardiomyopathy and Guiding Substrate Ablation in Atrial Fibrillation: A Narrative ReviewJean Pierre Jabbour0Marta Palombi1Michela Bonanni2Andrea Matteucci3Luca Arcari4Nicola Pierucci5Vincenzo Mirco La Fazia6Carlo Lavalle7Marco Valerio Mariani8Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, “Sapienza” University of Rome, 00185 Rome, ItalyDepartment of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, “Sapienza” University of Rome, 00185 Rome, ItalyDepartment of Experimental Medicine, Tor Vergata University, 00133 Rome, ItalyDepartment of Experimental Medicine, Tor Vergata University, 00133 Rome, ItalyCardiology Unit, Madre Giuseppina Vannini Hospital, Via di Acqua Bullicante 4, 00177 Rome, ItalyDepartment of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, “Sapienza” University of Rome, 00185 Rome, ItalyDepartment of Experimental Medicine, Tor Vergata University, 00133 Rome, ItalyDepartment of Internal Clinical, Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, 00185 Rome, ItalyDepartment of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, “Sapienza” University of Rome, 00185 Rome, ItalyCardiac magnetic resonance imaging (MRI) is increasingly recognized as a promising tool for tissue characterization in atrial fibrillation (AF), providing detailed insights into anatomy, fibrosis, and scarring. While MRI cannot directly guide ablation lesions, its ability to identify arrhythmogenic substrates could improve patient stratification and procedural planning. Despite these theoretical advantages, the clinical utility of MRI in guiding substrate-based ablation strategies remains a matter of debate. Methods: Our review evaluates the current evidence supporting the integration of MRI into the workflow of AF ablation. Specifically, we examine findings from randomized trials and prospective studies that have investigated the predictive value of MRI-derived fibrosis quantification for procedural outcomes and arrhythmia recurrence. We aim to assess whether MRI can enhance the personalization of ablation strategies and predict treatment success. Challenges such as variability in imaging protocols, lack of standardization in fibrosis quantification, and limited large-scale validation are also addressed. This review provides a comprehensive overview of the current status and potential of MRI in the evolving field of AF ablation.https://www.mdpi.com/2308-3425/12/4/114cardiac magnetic resonanceatrial cardiomyopathyatrial fibrillationatrial fibrillation ablation |
| spellingShingle | Jean Pierre Jabbour Marta Palombi Michela Bonanni Andrea Matteucci Luca Arcari Nicola Pierucci Vincenzo Mirco La Fazia Carlo Lavalle Marco Valerio Mariani The Role of Cardiac Magnetic Resonance in Characterizing Atrial Cardiomyopathy and Guiding Substrate Ablation in Atrial Fibrillation: A Narrative Review Journal of Cardiovascular Development and Disease cardiac magnetic resonance atrial cardiomyopathy atrial fibrillation atrial fibrillation ablation |
| title | The Role of Cardiac Magnetic Resonance in Characterizing Atrial Cardiomyopathy and Guiding Substrate Ablation in Atrial Fibrillation: A Narrative Review |
| title_full | The Role of Cardiac Magnetic Resonance in Characterizing Atrial Cardiomyopathy and Guiding Substrate Ablation in Atrial Fibrillation: A Narrative Review |
| title_fullStr | The Role of Cardiac Magnetic Resonance in Characterizing Atrial Cardiomyopathy and Guiding Substrate Ablation in Atrial Fibrillation: A Narrative Review |
| title_full_unstemmed | The Role of Cardiac Magnetic Resonance in Characterizing Atrial Cardiomyopathy and Guiding Substrate Ablation in Atrial Fibrillation: A Narrative Review |
| title_short | The Role of Cardiac Magnetic Resonance in Characterizing Atrial Cardiomyopathy and Guiding Substrate Ablation in Atrial Fibrillation: A Narrative Review |
| title_sort | role of cardiac magnetic resonance in characterizing atrial cardiomyopathy and guiding substrate ablation in atrial fibrillation a narrative review |
| topic | cardiac magnetic resonance atrial cardiomyopathy atrial fibrillation atrial fibrillation ablation |
| url | https://www.mdpi.com/2308-3425/12/4/114 |
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