B-PO02-096 PREDICTION OF ATRIAL FIBRILLATION RECURRENCE POST-ABLATION BASED ON ATRIAL FIBROSIS BY LATE GADOLINIUM ENHANCEMENT: A META-ANALYSIS

Abstract

The degree of left atrial fibrosis has been identified as one of the independent predictors of the recurrence of atrial fibrillation (AF) post-ablation. Late gadolinium enhancement magnetic resonance imaging (LGE-MRI) has been known to predict the recurrence of AF post-ablation based on left atrial fibrosis in various observational studies. In this paper, we have systematically combined the studies performed that used LGE-MRI to quantify atrial fibrosis based on the different stages of fibrosis before ablation to predict AF's recurrence. This meta-analysis aims to investigate the recurrence of atrial AF post-ablation based on the various stages of fibrosis seen in the late gadolinium enhancement magnetic resonance imaging (LGE-MRI). Electronic databases were searched nine studies that met the inclusion criteria were identified. A total of 1,787 patients underwent LGE-MRI to assess atrial fibrosis before catheter ablation for AF. We performed three sets of analyses: first, compared stage IV versus stage I (reference group). The second set examined the combined stages III and IV versus stages I and II (reference group). The third set compared stage IV versus combined stages I, II, and III. The metanalysis relied on a random-effects model to pool the odds ratios (OR) and 95% confidence intervals (CI) using the DerSimonian and Laird method. The data was analyzed using StatsDirect software, England. The study showed a higher rate of AF recurrence after ablation in stage IV atrial fibrosis compared with those in stage I (OR, 9.54; 95% CI, 3.81 to 28.89; P<00001). Also, in patients with combined stages III & IV of atrial fibrosis, AF recurrence was significantly higher after ablation than stages I & II groups (OR, 2.37; 95% CI, 1.61 to 3.50; P<00001). Similarly, patients with stage IV compared to combined stages I, II, and III have higher odds of recurrence post-ablation (OR, 4.24; 95% CI, 2.39- 7.52, P < 0.001). This metanalysis demonstrates the strong association of left atrial fibrosis seen in LGE-MRI and AF post-ablation recurrence. The finding of this study will further assist clinicians in predicting the rate of recurrence of AF based on the amount of fibrosis and tailor therapeutic decisions for further management.