Assessment of Left Atrial Structure and Function by Echocardiography in Atrial Fibrillation

Abstract

Atrial fibrillation (AF) is the most common arrhythmia with significant morbidity and mortality. Exacerbated by the aging population, the prevalence of AF is gradually increasing. Accurate evaluation of structure and function of left atrium (LA) has important prognostic significance in patients with AF. Echocardiography is the imaging technique of first choice to assess LA structure and function due to its better availability, accessibility and safety over cardiac computed tomography and cardiac magnetic resonance. Therefore, the aim of this review is to summarize the recent research progress of evaluating LA size by three-dimensional echocardiography and LA function by speckle tracking echocardiography (STE) in predicting the occurrence and recurrence of AF and determining the risk of stroke in AF. In addition, we summarized the role of traditional echocardiography in detecting AF patients that are at high risk of heart failure or cardiovascular death.

Multimodality Imaging in Patients with Hypertrophic Cardiomyopathy and Atrial Fibrillation

“…Furthermore, LA function can be assessed using tissue Doppler imaging (TDI) or speckle-tracking (ST) measurements of LA strain and strain rate [32]. However, the angle dependency of the method is a critical limitation of TDI-derived strain measurement [33]. If the angle of interrogation exceeds 20 degrees, the velocity could be underestimated.…”

Value of Imaging in the Non-Invasive Prediction of Recurrence after Catheter Ablation in Patients with Atrial Fibrillation: An Up-to-Date Review

“…Echocardiography is the preferred modality for evaluating left atrial (LA) structure and function because it is more convenient, cost-effective, and safer than cardiac CT and MRI [ 7 ]. Multiple studies have identified that a larger LA diameter [ 16 , 17 , 18 , 19 ] and volume [ 7 , 15 , 20 , 21 ] measured via transthoracic echocardiography before CA are associated with a higher probability of AF recurrence. Moreover, the LA volume index, calculated by dividing LA volume by body surface area, including the maximum, mean, minimum, and volume index, was relevant to AF recurrence after CA [ 22 , 23 , 24 ].…”

“…Studies have reported that increased EAT thickness measured using ultrasound is significantly associated with AF recurrence after CA and that this association is mainly related to pro-inflammatory cytokine release in EAT [ 23 , 29 , 30 ]. Moreover, speckle tracking echocardiography (STE) is an advanced, non-invasive echocardiographic technique independent of the angle of sound waves and has great potential for clinical application [ 7 ]. Nielsen et al .…”

“…However, it should be noted that some patients with AF have a recurrence rate of up to 30% following CA and that approximately 10% of cases of AF are not terminated following CA [ 7 ]. Moreover, complications caused by CA, such as atrioesophageal fistula and cardiac tamponade, should not be ignored [ 8 ].…”

“…Moreover, complications caused by CA, such as atrioesophageal fistula and cardiac tamponade, should not be ignored [ 8 ]. Consequently, identifying patient groups at a higher risk of recurrent AF can help ensure a higher success rate after CA and avoid unnecessary risks associated with invasive procedures [ 2 , 7 ]. This also helps clinicians develop appropriate treatment and prevention strategies for patients with AF and adjust the rhythm control approach after CA promptly [ 9 ].…”