The understanding of atrial fibrillation (AF) evolved from a sole rhythm disturbance towards the complex concept of a cardiomyopathy based on arrhythmia substrates. There is evidence that atrial fibrosis can be visualized using late gadolinium enhancement cardiac magnetic resonance imaging and that it is a powerful predictor for the outcome of AF interventions. However, a strategy of an individual and fibrosis guided management of AF looks promising but results from prospective multicentre trials are pending. This review gives an overview about the relationship between cardiac fibrosis and AF focusing on translational aspects, clinical observations, and fibrosis imaging to emphasize the concept of personalized paths in AF management taking into account the individual amount and distribution of fibrosis.

中文翻译：

---

心房颤动和心脏纤维化

对心房颤动 (AF) 的理解从单一的节律紊乱发展为基于心律失常基质的心肌病的复杂概念。有证据表明，使用晚期钆增强心脏磁共振成像可以显示心房纤维化，并且它是 AF 干预结果的有力预测指标。然而，个体化和纤维化指导的 AF 管理策略看起来很有希望，但前瞻性多中心试验的结果尚待确定。本综述概述了心脏纤维化和 AF 之间的关系，重点是转化方面、临床观察和纤维化成像，以强调 AF 管理中个性化路径的概念，同时考虑到纤维化的个体数量和分布。