{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T20:29:05Z","timestamp":1783542545527,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Atrial fibrosis is an adverse factor for arrhythmia recurrences and thromboembolic events in atrial fibrillation (AF). Cardiac magnetic resonance imaging (CMRi) has emerged as a noninvasive tool for its assessment, though evidence remains conflicting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>\n                      Sixty ablation\u2010na\u00efve patients with AF scheduled for first\u2010time catheter ablation were enrolled (78% men, 67% paroxysmal AF, 73% heart failure reduced ejection fraction [HFrEF]). Prior to the procedure, CMRi was performed in sinus rhythm (SR) on a 1.5T system using a high\u2010resolution (1.3\u2009mm isotropic) free\u2010breathing 3D LGE sequence with echo\u2010navigator end\u2010expiratory gating and whole\u2010heart coverage. Left atrium (LA) fibrosis was quantified using the commercially available ADAS 3D software, with fibrosis defined at four image intensity ratios (IIR) thresholds (0.97, 1.2, 1.32, and 1.61 times mean blood\u2010pool signal intensity). High\u2010density electroanatomical mapping (EAM) was performed in SR, and low\u2010voltage substrates (LVS) were quantified at three bipolar voltage thresholds (0.5, 0.25, and 0.1\u2009mV). LVS\u2010EAM were identified in 97%, 88%, and 45% of patients at 0.5, 0.25, and 0.1\u2009mV, respectively. LGE\u2010CMRi was detected in 100%, 97%, 63%, and 17% of patients at IIR thresholds of 0.97, 1.2, 1.32, and 1.61, respectively. Quantitative correlation between CMR\u2010 and EAM\u2010derived fibrosis was negligible to weak across all threshold combinations. When fibrosis was analyzed dichotomously, agreement was highest between EAM 0.5\u2009mV and CMR IIR 0.97 (0.97, 95% CI [0.92, 1.00];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and IIR 1.2 (1, 95% CI [1.00, 1.00];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and between EAM 0.25\u2009mV and CMR IIR 0.97 (0.87 95% CI [0.76, 0.97];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and IIR 1.2 (0.9, 95% CI [0.81, 0.99];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In an ablation\u2010na\u00efve AF population with a predominance of HFrEF patients, CMR\u2010 and EAM\u2010derived measures of atrial fibrosis showed poor quantitative correlation across multiple threshold combinations. Although agreement improved when fibrosis was analyzed dichotomously (presence vs. absence of fibrosis), the highest agreement was observed at the most sensitive threshold combinations. The findings of our study highlight the need for standardized, validated, and reproducible CMR protocols for native atrial fibrosis assessment in order to provide a noninvasive alternative to EAM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70447","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T19:53:14Z","timestamp":1783540394000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Atrial Fibrosis Imaging: Correlation of Late Gadolinium Enhancement Magnetic Resonance Imaging With High\u2010Definition Voltage Electroanatomical Mapping Across Different Thresholds"],"prefix":"10.1111","author":[{"given":"Theodoros","family":"Efremidis","sequence":"first","affiliation":[{"name":"Arrhythmia Unit Onassis Hospital Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Nyktari","sequence":"additional","affiliation":[{"name":"CMR Unit Onassis Hospital Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9162-6039","authenticated-orcid":false,"given":"Ourania","family":"Kariki","sequence":"additional","affiliation":[{"name":"Arrhythmia Unit Onassis Hospital Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5411-6461","authenticated-orcid":false,"given":"Konstantinos","family":"Pamporis","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Social\u2010Preventive Medicine &amp; Medical Statistics, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Saplaouras","sequence":"additional","affiliation":[{"name":"Arrhythmia Unit Onassis Hospital Athens 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Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos P.","family":"Letsas","sequence":"additional","affiliation":[{"name":"Arrhythmia Unit Onassis Hospital Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Efremidis","sequence":"additional","affiliation":[{"name":"Arrhythmia Unit Onassis Hospital Athens 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