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Atrial cardiomyopathy: Diagnosis, clinical implications and unresolved issues in anticoagulation therapy

Ourania Kariki1, Konstantinos Vlachos1, Stylianos Dragasis1

  • 1Arrhythmia Unit, Onassis Cardiac Surgery Center, 17674 Athens, Greece.

Journal of Electrocardiology
|November 12, 2022
PubMed

Insights

Atrial cardiomyopathy (AC) is a heart condition linked to stroke risk and reduced atrial fibrillation ablation success. Recognizing AC aids in understanding cardiac events and predicting treatment outcomes.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Pathophysiology

Background:

  • Atrial cardiomyopathy (AC) is a key factor in atrial arrhythmogenesis and cardiac thromboembolism.
  • Pathological changes in AC include myocardial dysfunction, fibrosis, and prothrombotic factor secretion.
  • AC contributes to the risk of ischemic stroke and embolic strokes of undetermined source.

Purpose of the Study:

  • To elucidate the role of atrial cardiomyopathy in cardiac arrhythmias and thromboembolic events.
  • To highlight diagnostic markers for atrial cardiomyopathy.
  • To explore the clinical implications of AC in stroke risk and atrial fibrillation ablation outcomes.

Main Methods:

  • Non-invasive diagnostics: electrocardiography, echocardiography, cardiac magnetic resonance imaging.
  • Invasive diagnostics: high-density electroanatomical mapping to identify low bipolar voltage areas.
  • Association studies linking AC signs to stroke risk and ablation success rates.

Main Results:

  • AC is associated with increased risk of ischemic and embolic strokes, independent of atrial fibrillation.
  • The presence of AC negatively correlates with the success of catheter ablation for atrial fibrillation.
  • AC provides insights into the mechanisms of cardioembolic cerebrovascular events.

Conclusions:

  • Atrial cardiomyopathy is a significant predictor of stroke and impacts atrial fibrillation management.
  • Diagnostic tools can identify AC, aiding in risk stratification.
  • Understanding AC offers a new perspective on preventing cardioembolic events and optimizing ablation therapies.

Keywords:
AnticoagulationAtrial cardiomyopathyAtrial fibrillationESUSStroke

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