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Review
. 2021 Dec;10(4):225-229.
doi: 10.15420/aer.2021.51.

Atrial Fibrosis, Ischaemic Stroke and Atrial Fibrillation

Christian Mahnkopf  1 , Younghoon Kwon  2 , Nazem Akoum  2
Affiliations
Review

Atrial Fibrosis, Ischaemic Stroke and Atrial Fibrillation

Christian Mahnkopf et al. Arrhythm Electrophysiol Rev. 2021 Dec.

Abstract

Atrial fibrosis is an important component of the arrhythmic substrate in AF. Evidence suggests that atrial fibrosis also plays a role in increasing the risk of stroke in patients with the arrhythmia. Patients with embolic stroke of undetermined source (ESUS), who are suspected to have AF but are rarely shown to have it, frequently demonstrate evidence of atrial fibrosis; measured using late-gadolinium enhancement MRI, this manifests as atrial remodelling encompassing structural, functional and electrical properties. In this review, the authors discuss the available evidence linking atrial disease, including fibrosis, with the risk of ischaemic stroke in AF, as well as in the ESUS population, in whom it has been linked to recurrent stroke and new-onset AF. They also discuss the implications of this association on future research that may elucidate the mechanism of stroke and stroke prevention strategies in the AF and ESUS populations.

Keywords: AF; Atrial fibrosis; embolic stroke of undetermined source.

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Conflict of interest statement

Disclosure: The authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Atrial Fibrosis With Embolic Figure 2: Outcome by Degree of Fibrosis Stroke of Undetermined Source
Figure 2:
Figure 2:. Outcome by Degree of Fibrosis
See this image and copyright information in PMC

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