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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Atrial Fibrosis, Ischaemic Stroke and Atrial Fibrillation

Christian Mahnkopf1, Younghoon Kwon2, Nazem Akoum2

  • 1Cardiology Department, Klinikim Coburg Coburg, Germany.

Arrhythmia & Electrophysiology Review
|February 2, 2022
PubMed

Insights

Atrial fibrosis, a key factor in atrial fibrillation (AF), increases stroke risk. This review explores the link between atrial disease, fibrosis, and stroke in AF and embolic stroke of undetermined source (ESUS) patients.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Atrial fibrosis is integral to the arrhythmic substrate in atrial fibrillation (AF).
  • Atrial fibrosis is increasingly recognized as a contributor to stroke risk in AF patients.
  • Embolic stroke of undetermined source (ESUS) patients often exhibit atrial fibrosis, suggesting a link to AF and recurrent stroke.

Purpose of the Study:

  • To review the evidence connecting atrial disease and fibrosis with ischemic stroke risk in AF.
  • To examine the association between atrial fibrosis and stroke in the ESUS population.
  • To discuss implications for future research on stroke mechanisms and prevention in AF and ESUS.

Main Methods:

  • Review of existing scientific literature and evidence.
  • Analysis of studies measuring atrial fibrosis using late-gadolinium enhancement MRI.
  • Examination of atrial remodeling encompassing structural, functional, and electrical properties.

Main Results:

  • Atrial fibrosis is a significant factor in AF-related stroke.
  • Atrial fibrosis is linked to recurrent stroke and new-onset AF in ESUS patients.
  • Late-gadolinium enhancement MRI reveals atrial remodeling associated with fibrosis.

Conclusions:

  • Atrial fibrosis is a critical link between AF and stroke risk.
  • Understanding atrial fibrosis is crucial for stroke prevention strategies in AF and ESUS.
  • Further research is needed to elucidate stroke mechanisms and refine prevention in these populations.

Keywords:
AFAtrial fibrosisembolic stroke of undetermined source

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