{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:55:59Z","timestamp":1791399359994,"version":"4.3.3"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T00:00:00Z","timestamp":1672272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100008666","name":"Fundaci\u00f3 la Marat\u00f3 de TV3","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008666","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>With recurrence rates up to 50% after pulmonary vein isolation (PVI) in persistent atrial fibrillation (AF), predictive tools to improve patient selection are needed. Patient selection based on left atrial late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) has been proposed previously (UTAH-classification). However, this approach has not been widely established, in part owed to the lack of standardization of the LGE quantification method. We have recently established a standardized LGE-CMR method enabling reproducible LGE-quantification. Here, the ability of this method to predict outcome after PVI was evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>This dual-centre study (n = 219) consists of a prospective derivation cohort (n = 37, all persistent AF) and an external validation cohort (n = 182; 66 persistent, 116 paroxysmal AF). All patients received an LGE-CMR prior to first-time PVI-only ablation. LGE was quantified based on the signal-intensity-ratio relative to the blood pool, applying a uniform LGE-defining threshold of &amp;gt;1.2. \u00a0In patients with persistent AF in the derivation cohort, left atrial LGE-extent above a cut-off value of 12% was found to best predict relevant low-voltage substrate (\u22652\u2005cm two with &amp;lt;0.5\u2005mV during sinus rhythm) and arrhythmia-free survival 12 months post-PVI. When applied to the external validation cohort, this cut-off value was also predictive of arrhythmia-free survival for both, the total cohort and the subgroup with persistent AF (LGE &amp;lt; 12%: 80% and 76%; LGE &amp;gt; 12%: 55% and 44%; P = 0.007 and P = 0.029, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This dual-centre study established and validated a standardized, reproducible LGE-CMR method discriminating PVI responders from non-responders, which may improve choice of therapeutic approach or ablation strategy for patients with persistent AF.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ehjopen\/oeac085","type":"journal-article","created":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T18:21:48Z","timestamp":1672338108000},"source":"Crossref","is-referenced-by-count":6,"title":["Predictive value of late gadolinium enhancement cardiovascular magnetic resonance in patients with persistent atrial fibrillation: dual-centre validation of a standardized method"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3289-2985","authenticated-orcid":false,"given":"Till F","family":"Althoff","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednic Cardiovascular Institute (ICCV), Universitat de Barcelona , C\/Villarroel N\u00b0 170, 08036 Barcelona, Catalonia , Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) , Carrer del Rossell\u00f3, 149, 08036 Barcelona , Spain"},{"name":"Department of Cardiology and Angiology, Charit\u00e9\u2014University Medicine Berlin , Charit\u00e9 Campus Mitte, Charit\u00e9platz 1, 10117 Berlin , Germany"},{"name":"DZHK (German Centre for Cardiovascular Research) , Potsdamer Str. 58, 10785 Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Eichenlaub","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Angiology, 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