Proximity to the descending aorta predicts regional fibrosis in the adjacent left atrial wall: aetiopathogenic and prognostic implications

• Published in: Europace (London, England) England), 2021-10, Vol.23 (10), p.1559-1567
• Main Authors: Caixal, Gala, Althoff, Till, Garre, Paz, Alarcón, Francisco, NuñezGarcia, Marta, Benito, Eva Maria, Borras, Roger, Perea, Rosario J, Prat-González, Susana, Gunturiz, Clara, Sanchez, Paula, Olivas, Dahyr, Tolosana, J Maria, Arbelo, Elena, Roca-Luque, Ivo, Brugada, Josep, Sitges, Marta, Guasch, Eduard, Mont, Lluis
• Format: Article
• Language: English
• ISSN: 1099-5129; 1532-2092
• DOI: 10.1093/europace/euab107

Abstract Aims Left atrial (LA) fibrosis is present in patients with atrial fibrillation (AF) and can be visualized by magnetic resonance imaging with late gadolinium enhancement (LGE-MRI). Previous studies have shown that LA fibrosis is not randomly distributed, being more frequent in the area adjacent to the descending aorta (DAo). The objective of this study is to analyse the relationship between fibrosis in the atrial area adjacent to the DAo and the distance to it, as well as the prognostic implications of this fibrosis. Methods and results Magnetic resonance imaging with late gadolinium enhancement was obtained in 108 patients before AF ablation to analyse the extent of LA fibrosis and the distance DAo-to-LA. A high-density electroanatomic map was performed in a subgroup of 16 patients to exclude the possibility of an MRI artifact. Recurrences after ablation were analysed at 1 year of follow-up. The extent of atrial fibrosis in the area adjacent to the DAo was inversely correlated with the distance DAo-to-LA (r = −0.34, P