{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:25:09Z","timestamp":1792686309919,"version":"4.5.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Myocardial fibrosis is key for atrial fibrillation maintenance. We aimed to test the efficacy of ablating cardiac magnetic resonance (CMR)-detected atrial fibrosis plus pulmonary vein isolation (PVI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This was an open-label, parallel-group, randomized, controlled trial. Patients with symptomatic drug-refractory atrial fibrillation (paroxysmal and persistent) undergoing first or repeat ablation were randomized in a 1:1 basis to receive PVI plus CMR-guided fibrosis ablation (CMR group) or PVI alone (PVI-alone group). The primary end point was the rate of recurrence (&gt;30 seconds) at 12 months of follow-up using a 12-lead ECG and Holter monitoring at 3, 6, and 12 months. The analysis was conducted by intention-to-treat.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In total, 155 patients (71% male, age 59\u00b110, CHA\n                      <jats:sub>2<\/jats:sub>\n                      DS\n                      <jats:sub>2<\/jats:sub>\n                      -VASc 1.3\u00b11.1, 54% paroxysmal atrial fibrillation) were allocated to the PVI-alone group (N=76) or CMR group (N=79). First ablation was performed in 80% and 71% of patients in the PVI-alone and CMR groups, respectively. The mean atrial fibrosis burden was 12% (only \u224850% of patients had fibrosis outside the pulmonary vein area). One hundred percent and 99% of patients received the assigned intervention in the PVI-alone and CMR group, respectively. The primary outcome was achieved in 21 patients (27.6%) in the PVI-alone group and 22 patients (27.8%) in the CMR group (odds ratio: 1.01 [95% CI, 0.50\u20132.04];\n                      <jats:italic>P<\/jats:italic>\n                      =0.976). There were no differences in the rate of adverse events (3 in the CMR group and 2 in the PVI-alone group;\n                      <jats:italic>P<\/jats:italic>\n                      =0.68).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>A pragmatic ablation approach targeting CMR-detected atrial fibrosis plus PVI was not more effective than PVI alone in an unselected population undergoing atrial fibrillation ablation with low fibrosis burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifier: NCT02698631.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.120.008707","type":"journal-article","created":{"date-parts":[[2020,10,8]],"date-time":"2020-10-08T19:01:26Z","timestamp":1602183686000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":76,"title":["Magnetic Resonance Imaging-Guided Fibrosis Ablation for the Treatment of Atrial Fibrillation"],"prefix":"10.1161","volume":"13","clinical-trial-number":[{"clinical-trial-number":"nct02698631","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4843-7063","authenticated-orcid":true,"given":"Felipe","family":"Bisbal","sequence":"first","affiliation":[{"name":"Heart Institute (iCor), University Hospital Germans Trias i Pujol, Badalona, Catalonia (F.B., A.T., A.S., R.V., N.S., G.J., V.B., A.B.-G.)."},{"name":"CIBERCV, Instituto de Salud Carlos III, Madrid (F.B., A.B.-G., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Benito","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain (E.B., F.A., G.C., P.G., J.C., E.G., S.P.-G., R.J.P., J.M.T., E.A., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Teis","sequence":"additional","affiliation":[{"name":"Heart Institute (iCor), University Hospital Germans Trias i Pujol, Badalona, Catalonia (F.B., A.T., A.S., R.V., N.S., G.J., V.B., A.B.-G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Alarc\u00f3n","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain (E.B., F.A., G.C., P.G., J.C., E.G., S.P.-G., R.J.P., J.M.T., E.A., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Sarrias","sequence":"additional","affiliation":[{"name":"Heart Institute (iCor), University Hospital Germans Trias i Pujol, Badalona, Catalonia (F.B., A.T., A.S., R.V., N.S., G.J., V.B., A.B.-G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gala","family":"Caixal","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain (E.B., F.A., G.C., P.G., J.C., E.G., S.P.-G., R.J.P., J.M.T., E.A., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9110-905X","authenticated-orcid":true,"given":"Roger","family":"Villuendas","sequence":"additional","affiliation":[{"name":"Heart Institute (iCor), University Hospital Germans Trias i Pujol, Badalona, Catalonia (F.B., A.T., A.S., R.V., N.S., G.J., V.B., A.B.-G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0191-2776","authenticated-orcid":true,"given":"Paz","family":"Garre","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain (E.B., F.A., G.C., P.G., J.C., E.G., S.P.-G., R.J.P., J.M.T., E.A., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2633-3623","authenticated-orcid":true,"given":"Nina","family":"Soto","sequence":"additional","affiliation":[{"name":"Heart Institute (iCor), University Hospital Germans Trias i Pujol, Badalona, Catalonia (F.B., A.T., A.S., R.V., N.S., G.J., V.B., A.B.-G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Cozzari","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain (E.B., F.A., G.C., P.G., J.C., E.G., S.P.-G., R.J.P., J.M.T., E.A., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4238-5319","authenticated-orcid":true,"given":"Eduard","family":"Guasch","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain (E.B., F.A., G.C., P.G., J.C., E.G., S.P.-G., R.J.P., J.M.T., E.A., L.M.)."},{"name":"Institut d\u2019Investigaci\u00f3 Biom\u00e8dica August Pi I Sunyer (IDIBAPS), Barcelona, Catalonia, Spain (E.G, L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4421-5658","authenticated-orcid":true,"given":"Gladys","family":"Junc\u00e0","sequence":"additional","affiliation":[{"name":"Heart Institute (iCor), University Hospital Germans Trias i Pujol, Badalona, Catalonia (F.B., A.T., A.S., R.V., N.S., G.J., V.B., A.B.-G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Prat-Gonzalez","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain (E.B., F.A., G.C., P.G., J.C., E.G., S.P.-G., R.J.P., J.M.T., E.A., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario J.","family":"Perea","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain (E.B., F.A., G.C., P.G., J.C., E.G., S.P.-G., R.J.P., J.M.T., E.A., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Baz\u00e1n","sequence":"additional","affiliation":[{"name":"Heart Institute (iCor), University Hospital Germans Trias i Pujol, Badalona, Catalonia (F.B., A.T., A.S., R.V., N.S., G.J., V.B., A.B.-G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"Tolosana","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain (E.B., F.A., G.C., P.G., J.C., E.G., S.P.-G., R.J.P., J.M.T., E.A., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0424-6393","authenticated-orcid":true,"given":"Elena","family":"Arbelo","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Hospital Clinic, University of Barcelona, Spain (E.B., F.A., G.C., P.G., J.C., E.G., S.P.-G., R.J.P., J.M.T., E.A., L.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3044-197X","authenticated-orcid":true,"given":"Antoni","family":"Bay\u00e9s-Gen\u00eds","sequence":"additional","affiliation":[{"name":"Heart Institute (iCor), University Hospital Germans Trias i Pujol, Badalona, Catalonia (F.B., A.T., A.S., R.V., N.S., G.J., V.B., A.B.-G.)."},{"name":"CIBERCV, Instituto de 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Arrhythmia and Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCEP.120.008707","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T03:31:33Z","timestamp":1738812693000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCEP.120.008707"}},"subtitle":["The ALICIA Trial"],"short-title":[],"issued":{"date-parts":[[2020,11]]},"references-count":24,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1161\/CIRCEP.120.008707"],"URL":"https:\/\/doi.org\/10.1161\/circep.120.008707","relation":{},"ISSN":["1941-3149","1941-3084"],"issn-type":[{"value":"1941-3149","type":"print"},{"value":"1941-3084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11]]},"assertion":[{"value":"2019-04-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e008707"}}