Abstract
Marrouche et al (JAMA 2022;327:2296, PMID 35727277) investigated targeting atrial fibrosis detected on magnetic resonance imaging (MRI) in reducing atrial arrhythmia recurrence in persistent AF. A total of 843 patients with persistent AF were randomized to pulmonary vein isolation (PVI) plus MRI-guided atrial fibrosis ablation (421 patients) or PVI alone (422 patients). The primary end point was time to first atrial arrhythmia recurrence after a 90-day blanking period postablation. There was no significant difference in atrial arrhythmia recurrence between groups (fibrosis-guided ablation plus PVI patients, 175 [43.0%] vs PVI-only patients 188 [46.1%]; hazard ratio [HR] 0.95; P = .63).
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