Left atrial fibrosis in atrial fibrillation: Mechanisms, clinical evaluation and management

J Cell Mol Med. 2021 Mar;25(6):2764-2775. doi: 10.1111/jcmm.16350. Epub 2021 Feb 11.


Atrial fibrillation (AF), the commonest arrhythmia, shows associations with various disease conditions. Mounting evidence indicates that atrial fibrosis is an important part of the arrhythmogenic substrate, with an essential function in the generation of conduction abnormalities that underlie the transition from paroxysmal to persistent AF, which in turn contributes to AF perpetuation. Left atrial (LA) fibrosis is considered a possible major factor and predictor in AF treatment. The present review provides insights into LA fibrosis' association with AF. The information is focused on clinical aspects and mechanisms, clinical evaluating methods that evaluate fibrosis changes and examining possible options for the prevention of atrial fibrosis.

Keywords: arrhythmia; atrium; cardiovascular imaging; electrophysiology; fibrosis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / pathology*
  • Atrial Fibrillation / physiopathology
  • Biomarkers
  • Disease Susceptibility
  • Echocardiography
  • Electrocardiography
  • Fibroblasts / metabolism
  • Fibrosis
  • Heart Atria / pathology*
  • Humans
  • Magnetic Resonance Imaging
  • Myofibroblasts / metabolism
  • Recurrence


  • Biomarkers