State-of-the-Art Review
Multimodality Imaging for Best Dealing With Patients in Atrial Arrhythmias

https://doi.org/10.1016/j.jcmg.2018.06.031Get rights and content
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Highlights

  • Atrial anatomy and functions are key and should not be forgotten by imagers. There are key pathophysiological, prognostic, and therapeutic values in analyzing the left, and probably also the right, atria.

  • Atrial volumes are important; atrial deformation during the reservoir and probably also during the active booster pump function have to be considered.

  • Cardiac computed tomography as well as cardiac magnetic resonance imaging have important roles, also for assessing atrial anatomy, characterizing tissue, and guiding for treatment strategies.

  • Data from many proof-of-concept and large, prospective, interventional studies have been missing until now in the field of imaging the atria.

Abstract

The management of atrial fibrillation (AF) is not only a clinical challenge but also an imaging challenge. The role of different imaging modalities to estimate the thromboembolic risk in AF is a key clinical question. The present review summarizes the advances of myocardial imaging in the stratification of thromboembolic risk, diagnosis, and management of left atrial thrombosis in patients with AF. These imaging techniques are also important for understanding arrhythmias and their consequences. It is becoming fundamental for guiding therapy. Still, large studies are required, but be sure that left atrial imaging will become more and more clinically fundamental.

Key Words

atrial fibrillation
cardiac magnetic resonance
echocardiography
electroanatomic mapping
strain

Abbreviations and Acronyms

2D
2-dimensional
3D
3-dimensional
AF
atrial fibrillation
CMR
cardiac magnetic resonance
CT
computed tomography
FIRM
focal impulse and rotor modulation
LA
left atrial/atrium
LAA
left atrial appendage
LGE
late gadolinium enhancement
PV
pulmonary vein
SEC
spontaneous echocardiographic contrast
TEE
transesophageal echocardiography

Cited by (0)

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.