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Updated: Jul 17, 2025

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

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Elevated atrial blood stasis in paroxysmal atrial fibrillation during sinus rhythm: a patient-specific computational

Sophia Bäck1,2, Iulia Skoda3, Jonas Lantz1,2

  • 1Unit of Cardiovascular Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.

Frontiers in Cardiovascular Medicine
|August 31, 2023
PubMed

Insights

Patients with atrial fibrillation (AF) show increased blood stasis in the left atrium, even during sinus rhythm. Computational fluid dynamics revealed that this stasis is linked to ejection fraction and volume ratios, highlighting stroke risk.

Area of Science:

  • Cardiovascular Research
  • Medical Imaging
  • Computational Fluid Dynamics

Background:

  • Atrial fibrillation (AF) increases stroke risk due to thrombi forming in the left atrium (LA) and left atrial appendage (LAA).
  • Blood stasis in the LAA is a suspected cause, but difficult to measure due to anatomical constraints.
  • Understanding blood flow dynamics in AF patients is crucial for assessing stroke risk.

Purpose of the Study:

  • To compare blood flow and stasis in the left atrium of paroxysmal AF patients versus controls.
  • To utilize computational fluid dynamics (CFD) for patient-specific analysis of blood flow in the LA and LAA.
  • To identify factors associated with blood stasis in AF patients.

Main Methods:

  • Employed time-resolved computed tomography and patient-specific cardiac motion for CFD simulations.
  • Analyzed data from 21 paroxysmal AF patients and 8 control subjects.
  • Quantified blood stasis by calculating blood residence time within the left atrium.

Main Results:

  • Blood residence time, indicative of stasis, was significantly elevated in the AF group (p < 0.001).
  • Stasis strongly correlated with LA ejection ratio (R² = 0.68) and the ratio of LA volume to left ventricular stroke volume (R² = 0.81).
  • Elevated stroke risk from LA thrombi may exist in AF patients even during sinus rhythm.

Conclusions:

  • Blood stasis is a significant factor in atrial fibrillation patients, even in sinus rhythm.
  • CFD simulations offer a powerful tool for assessing LAA blood flow and stasis.
  • Patient-specific CFD analysis holds potential for improving stroke risk assessment and guiding treatment in AF.
Abstract

Keywords:
atrial cardiomyopathyatrial fibrillationcomputational fluid dynamicscomputed tomographyleft atrial appendagestroke

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