Related Experiment Video
Updated: Dec 7, 2025

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Atrial Myopathy Underlying Atrial Fibrillation
Harold Rivner1, Raul D Mitrani1, Jeffrey J Goldberger1
1Cardiovascular Division, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, US.
Insights
Atrial myopathy, a key factor in atrial fibrillation (AF), is often overlooked in current treatments. Targeting this underlying condition, particularly atrial fibrosis, shows promise in reducing AF occurrence and burden.
Area of Science:
- Cardiology
- Electrophysiology
- Biomedical Engineering
Background:
- Atrial fibrillation (AF) commonly arises from underlying atrial disease.
- Current AF assessment and treatment strategies do not adequately address the contributing atrial myopathy.
- Atrial myopathy, including fibrosis, can create a cycle where it leads to AF, which then exacerbates the myopathy.
Purpose of the Study:
- To highlight the significance of atrial myopathy as a substrate for AF.
- To emphasize the need for therapies that target the underlying atrial myopathy.
- To review current methods for assessing atrial myopathy and discuss emerging therapeutic approaches.
Main Methods:
- Review of existing literature on atrial myopathy and AF.
- Discussion of diagnostic techniques: ECG, plasma biomarkers, electroanatomical voltage mapping, echocardiography, and cardiac MRI.
- Analysis of current AF treatments and their limitations regarding atrial myopathy.
Main Results:
- Atrial myopathy, especially fibrosis, is a critical substrate for AF.
- Existing diagnostic tools can identify and quantify aspects of atrial myopathy.
- Current AF treatments like catheter ablation do not directly resolve the underlying myopathy.
Conclusions:
- Addressing atrial myopathy is crucial for effective AF management.
- Emerging research suggests that targeting atrial myopathy can decrease AF incidence and burden.
- A shift towards treating the substrate of AF, rather than just the arrhythmia, is needed.
Abstract:
While AF most often occurs in the setting of atrial disease, current assessment and treatment of patients with AF does not focus on the extent of the atrial myopathy that serves as the substrate for this arrhythmia. Atrial myopathy, in particular atrial fibrosis, may initiate a vicious cycle in which atrial myopathy leads to AF, which in turn leads to a worsening myopathy. Various techniques, including ECG, plasma biomarkers, electroanatomical voltage mapping, echocardiography, and cardiac MRI, can help to identify and quantify aspects of the atrial myopathy. Current therapies, such as catheter ablation, do not directly address the underlying atrial myopathy. There is emerging research showing that by targeting this myopathy we can help decrease the occurrence and burden of AF.
Related Concept Videos
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Cardiomyopathy IV: Restrictive Cardiomyopathy
Cardiomyopathy III: Hypertrophic Cardiomyopathy
Rheumatic Heart Disease I: Introduction
Cardiomyopathy V: Interprofessional Care
Mechanism of Cardiac Arrhythmias

