60. Role of Late Gadolinium-Enhanced Magnetic Resonance Imaging in Detection and Quantification of Atrial Fibrosis

  1. Mohammad Shenasa MD2,
  2. Gerhard Hindricks MD3,
  3. Martin Borggrefe MD4,
  4. Günter Breithardt MD5 and
  5. Mark E. Josephson MD6
  1. Alexies Ramirez and
  2. Nassir F. Marrouche

Published Online: 18 DEC 2012

DOI: 10.1002/9781118481585.ch60

Cardiac Mapping, Fourth Edition

Cardiac Mapping, Fourth Edition

How to Cite

Ramirez, A. and Marrouche, N. F. (2013) Role of Late Gadolinium-Enhanced Magnetic Resonance Imaging in Detection and Quantification of Atrial Fibrosis, in Cardiac Mapping, Fourth Edition (eds M. Shenasa, G. Hindricks, M. Borggrefe, G. Breithardt and M. E. Josephson), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118481585.ch60

Editor Information

  1. 2

    Attending Physician, Department of Cardiovascular Services, O'Connor Hospital, Heart & Rhythm Medical Group, San Jose, California, USA

  2. 3

    Professor of Medicine (Cardiology), University Leipzig, Heart Center, Director, Department of Electrophysiology, Leipzig, Germany

  3. 4

    Professor of Medicine (Cardiology), Head, Department of Cardiology, Angiology and Pneumology, University Medical Center, Mannheim Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany

  4. 5

    Professor Emeritus of Medicine and Cardiology, Department of Cardiology and Angiology, Hospital of the University of Münster, Münster, Germany

  5. 6

    Chief, Cardiovascular Medicine Division, Director, Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service, Beth Israel Deaconess Medical Center, Herman C. Dana Professor of Medicine, Harvard Medical School, Boston, Massachusetts, USA

Author Information

  1. University of Utah Health Sciences Center, Salt Lake City, UT, USA

Publication History

  1. Published Online: 18 DEC 2012
  2. Published Print: 10 JAN 2013

ISBN Information

Print ISBN: 9780470670460

Online ISBN: 9781118481585



  • magnetic resonance imaging;
  • atrial fibrillation;
  • catheter ablation;
  • left atrial tissue remodelling;
  • atrial fibrosis;
  • endomyocardial biopsy;
  • myocardial inflammation;
  • 3D electroanatomical mapping system


Late gadolinium enhanced magnetic resonance imaging (LGE-MRI) of the left atrium has emerged as an integral and versatile modality with which to define the substrate mediating atrial fibrillation (AF) and to characterize the effects of radiofrequency catheter ablation on the atrial wall. LGE-MRI identifies left atrial tissue structural remodeling (LATR) or fibrosis as areas of hyperenhancement. The degree of LATR does not unequivocally relate to the duration of AF, nor to the phenotype (i.e., paroxysmal vs. persistent) of AF. Prospective clinical data has demonstrated that the success of AF ablation is inversely related to the extent of pre-ablation left atrial tissue structural remodeling and directly related to the amount of scarring from ablation. This observation has facilitated the development of a new substrate guided treatment strategy of AF based upon the degree of left atrial fibrosis.