Abstract
Atrial fibrillation (AF) is the most common arrhythmia among adults. While there have been incredible advances in the management of AF and its clinical sequelae, investigation of atrial cardiomyopathies (ACMs) is becoming increasingly more prominent. ACM refers to the electromechanical changes—appreciated subclinically and/or clinically—that underlie atrial dysfunction and create an environment ripe for the development of clinically apparent AF. There are several subtypes of ACM, distinguished by histologic features. Recent progress in cardiovascular imaging, including echocardiography with speckle-tracking (e.g., strain analysis), cardiovascular magnetic resonance imaging (CMR), and atrial 4-D flow CMR, has enabled increased recognition of ACM. Identification of ACM and its features carry clinical implications, including elevating a patient's risk for development of AF, as well as associations with outcomes related to catheter-based and surgical AF ablation. In this review, we explore the definition and classifications of ACM, its complex relationship with clinical AF, imaging modalities, and clinical implications. We propose next steps for a more unified approach to ACM recognition that can direct further research into this complex field.
Original language | English (US) |
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Pages (from-to) | 2845-2853 |
Number of pages | 9 |
Journal | Journal of cardiovascular electrophysiology |
Volume | 32 |
Issue number | 10 |
DOIs | |
State | Published - Oct 2021 |
Funding
James L. Cox is a cofounder, member of the board of directors, stockholder and consultant for Adagio Medical; stockholder and consultant for Atricure; stockholder and on the board of directors for PAVmed and Lucid Diagnostics; and serves as a stockholder and on the Clinical Advisory Board for PotentiaMetrics. Patrick M. McCarthy receives speaker fees from Atricure, Medtronic and Edwards Lifesciences, as well as royalties from Edwards Lifesciences. Ravi B. Patel is supported by the National Institutes of Health's National Center for Advancing Translational Sciences (KL2TR001424). Rod S. Passman reports consultant honoraria from Medtronic and Janssen, research support from Abbott, and royalties from UpToDate. Jane E. Wilcox receives funding from the NIH and AHA, reports speaker/consultant honoraria from Amgen, Medtronic and Boehringer Ingelheim, and serves on the Advisory Board for Cytokinetics. Other authors: No disclosures. Disclosures:
Keywords
- MRI
- atrial fibrillation
- cardiomyopathy
- echocardiography
- imaging
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)