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Multimodality imaging for thromboembolic risk assessment in atrial fibrillation

Todaro, Maria C.a; Solazzo, Antoniob; Senatore, Gaetanoa; Zito, Concettac; Di Bella, Gianlucac; Carerj, Maria L.d; Oreto, Giuseppec; Carerj, Scipionec

Journal of Cardiovascular Medicine: December 2018 - Volume 19 - Issue 12 - p 698–705
doi: 10.2459/JCM.0000000000000727

Atrial fibrillation is the most widely represented sustained arrhythmia in the world. Thromboembolic risk assessment represents the main clinical challenge associated with this condition, requiring enormous medical, social and economical efforts. Several pieces of evidence in literature highlight how clinical risk factors are not enough for a correct thromboembolic risk stratification of patients with atrial fibrillation, since thromboembolic events have been proven to occur even in patients with low clinical risk scores. A comprehensive multimodality imaging approach, with special regard to echocardiography and new technologies seems to be the best method for this purpose. The aim of this review is to propose a hybrid thromboembolic risk stratification system that combinines clinical evaluation with instrumental clues on left atrial remodeling, fibrosis and deformation which, could be useful especially for patients classified at low thromboembolic risk according to clinical scores.

aDepartment of Cardiology

bDepartment of Radiology, Ivrea Civil Hospital, Ivrea

cDepartment of Clinical and Experimental Medicine, Cardiology Section

dDepartment of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy

Correspondence to Maria C. Todaro, Ospedale Civile di Ivrea, Piazza della Credenza, 2, 10015 Ivrea, Province of Turin, Italy E-mail:

Received 23 June, 2018

Accepted 30 September, 2018

© 2018 Italian Federation of Cardiology. All rights reserved.