Early Echocardiographic Predictors for Atrial Fibrillation Propensity: The Left Atrium Oracle

Atrial fibrillation (AF) results from structural and electrical remodeling of the atria, primarily of the left atrium (LA); therefore, LA changes, both anatomical and functional arc recognized as proarrhythmic markers with a powerful prognostic value. Being widely available and noninvasive, echocardiography is used to monitor LA form and function in clinical practice. Early functional (electrical) remodeling of the LA precedes anatomical alterations. Impaired LA functions and reduced atrial compliance due to atrial fibrosis may be evaluated using novel echocardiographic techniques, such as tissue Doppler analysis and speckle tracking. Functional evaluation of the LA conveys prognostic information about the risk of AF, as the severity of the impairment is an independent predictor of new-onset AF and AF recurrence. However, specific parameters are still investigated for incorporation into algorithms to predict future AF occurrence. The aim of the review is to summarize echocardiographic parameters, their predicting value and applicability in practice.

Automated summary

Atrial fibrillation (AF) is a result of structural and electrical remodeling of the atria, particularly the left atrium (LA), and LA changes are recognized as important prognostic markers. Echocardiography is a widely available and noninvasive method used to monitor the form and function of the LA. Early functional remodeling of the LA precedes anatomical alterations. Advanced echocardiographic techniques can evaluate impaired LA functions and reduced atrial compliance due to atrial fibrosis. Functional evaluation of the LA provides prognostic information about the risk of AF.