ABC | Volume 114, Nº4, April 2020

Original Article Correia et al. CA lesions and AF recurrence - a meta-analysis Arq Bras Cardiol. 2020; 114(4):627-635 1. Wilber DJ, Pappone C, Neuzil P, De Paola A, Marchlinski F, Natale A, et al. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial. JAMA. 2010;303(4):333-40. 2. Weerasooriya R, Khairy P, Litalien J, Macle L, Hocini M, Sacher F, et al. Catheter ablation for atrial fibrillation: are results maintained at 5 years of follow-up? J Am Coll Cardiol. 2011;57(2):160-6. 3. Burstein B, Nattel S. Atrial fibrosis: mechanisms and clinical relevance in atrial fibrillation. J Am Coll Cardiol. 2008;51(8):802-9. 4. Nattel S, HaradaM. Atrial remodeling and atrial fibrillation: recent advances and translational perspectives. J Am Coll Cardiol. 2014;63(22):2335-45. 5. Allessie MA, Konings K, Kirchhof CJ, Wijffels M. Electrophysiologic mechanisms of perpetuation of atrial fibrillation. Am J Cardiol. 1996;77(3):10A-23A. 6. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283(15):2008-12. 7. National Heart, Lung, and Blood Institute. Quality Assessment Tool for Case Series Studies [Internet]. Maryland, USA: NIH; 2019 [cited 12 out 2018]. Available from: https://www.nhlbi.nih.gov/health-topics/study-quality- assessment-tools. 8. Higgins JP, Thompson SG. Quantifying heterogeneity in ameta-analysis. Stat Med. 2002;21(11):1539-58. 9. McGann CJ, Kholmovski EG, Oakes RS, Blauer JJ, Daccarett M, Segerson N, et al. New magnetic resonance imaging-based method for defining the extent of left atrial wall injury after the ablation of atrial fibrillation. J AmColl Cardiol. 2008;52(15):1263-71. 10. Peters DC, Wylie JV, Hauser TH, Nezafat R, Han Y, Woo JJ, et al. Recurrence of atrial fibrillation correlates with the extent of post-procedural late gadolinium enhancement: a pilot study. JACC Cardiovasc Imaging. 2009;2(3):308-16. 11. Badger TJ, Daccarett M, AkoumNW, Adjei-Poku YA, BurgonNS, HaslamTS, et al. Evaluation of left atrial lesions after initial and repeat atrial fibrillation ablation: lessons learned fromdelayed-enhancementMRI in repeat ablation procedures. Circ Arrhythm Electrophysiol. 2010;3(3):249-59. 12. AkoumN, Daccarett M, McGannC, SegersonN, VergaraG, Kuppahally S, et al. Atrial fibrosis helps select the appropriate patient and strategy in catheter ablation of atrial fibrillation: a DE-MRI guided approach. J Cardiovasc Electrophysiol. 2011;22(1):16-22. 13. McGann C, Kholmovski E, Blauer J, Vijayakumar S, Haslam T, Cates J, et al. Dark regions of no-reflow on late gadolinium enhancement magnetic resonance imaging result in scar formation after atrial fibrillation ablation. J Am Coll Cardiol. 2011;58(2):177-85. 14. Akoum N, Wilber D, Hindricks G, Jais P, Cates J, Marchlinski F, et al. MRI Assessment of ablation-induced scarring in atrial fibrillation: analysis from the DECAAF study. J Cardiovasc Electrophysiol. 2015;26(5):473-80. 15. Parmar BR, Jarrett TR, Kholmovski EG, Hu N, Parker D, MacLeod RS, et al. Poor scar formation after ablation is associated with atrial fibrillation recurrence. J Interv Card Electrophysiol. 2015;44(3):247-56. 16. Hunter RJ, Jones DA, Boubertakh R, Malcolme-Lawes LC, Kanagaratnam P, Juli CF, et al. Diagnostic accuracy of cardiac magnetic resonance imaging in the detection and characterization of left atrial catheter ablation lesions: a multicenter experience. J Cardiovasc Electrophysiol 2013;24(4):396-403. 17. Kheiri B, Osman M, Abdalla A, Haykal T, Ahmed S, Bachuwa G, et al. Catheter ablation of atrial fibrillation with heart failure: An updated meta- analysis of randomized trials. Int J Cardiol. 2018 Oct 15;269:170-3. 18. Wijffels MC, Kirchhof CJ, Dorland R, Allessie MA. Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats. Circulation. 1995;92(7):1954-68. 19. Li D, Fareh S, Leung TK, Nattel S. Promotion of atrial fibrillation by heart failure in dogs: atrial remodeling of a different sort. Circulation. 1999;100(1):87-95. 20. Yoon YE, Kim HJ, Kim SA, Kim SH, Park JH, Park KH, et al. Left atrial mechanical function and stiffness in patients with paroxysmal atrial fibrillation. J Cardiovasc Ultrasound. 2012;20(3):140-5. 21. Ágoston G, Szilágyi J, Bencsik G, Tutuianu C, Klausz G, Sághy L, et al. Impaired adaptation to left atrial pressure increase in patients with atrial fibrillation. J Interv Card Electrophysiol. 2015;44(2):113-8. 22. Sánchez-Quintana D, López-Mínguez JR, Pizarro G, MurilloM, Cabrera JA. Triggers and anatomical substrates in the genesis and perpetuation of atrial fibrillation. Curr Cardiol Rev. 2012;8(4):310-26. References CA (SMD = 0.52; 95% CI 0.27 – 0.76; p < 0.0001), which paves the way for scar-guided ablation strategies. However, the reproducibility of this imaging method needs to be further studied and improved. It is necessary to conduct randomized controlled trials, such as the DECAAF II trial, that investigate ablation methods based on this association in order to provide patients with the best treatment option, with minimal risk of AF recurrence and complications. Author contributions Conception and design of the research, Analysis and interpretation of the data, Writing of the manuscript and Critical revision of the manuscript for intellectual content: Correia ETO, Barbetta LMS, Mesquita ET; Acquisition of data: Correia ETO, Barbetta LMS; Statistical analysis: Correia ETO. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This study is not associatedwith any thesis or dissertationwork. Ethics approval and consent to participate This article does not contain any studies with human participants or animals performed by any of the authors. 633