N 4 (185) 2023. P. 69–74

THE ROLE OF CARDIAC STRUCTURAL REMODELING UNDER ATRIAL FIBRILLATION: IMAGING BASICS FOR PREDICTING RECURRENCE (LITERATURE REVIEW)

Yu. I. Karpenko, M. S. Maistrenko

Odesa National Medical University, Odesa, Ukraine

DOI https://doi.org/10.32782/2226-2008-2023-4-14

Atrial fibrillation (AF) is arrhythmia characterized by supraventricular rhythm disturbance, with chaotic electrical activity of the atria, the progression of which is associated with an increased risk of stroke and heart failure. It adversely affects the quality of life and prognosis and increases the level of hospitalization and mortality. Radiofrequency ablation of AF is the most effective method of treating patients with arrhythmias.

The most important predictor of progression and recurrence of AF is the structural and electromechanical remodeling of the atria, which occurs due to the arrhythmia itself, contributes to its progression, and develops tachy-induced cardiomyopathy.

The increased automaticity and trigger activity that occurs in the atria during structural remodeling can cause difficulties in maintaining sinus rhythm after ablation.

The most common method for assessing fibrous structural remodeling of the left ventricle is two- (2D) or three-dimensional (3D) echocardiography (EchoCG), involving measuring the size and volume of the left atrium (LV) or its function, as well as the degree of deformation via speckle tracking Echo-CG. The use of a set of indicators of the contractile function of the myocardium opens up the prospects of a personalized study of the compensatory capabilities of the heart and the choice of treatment tactics.

Thus, we can conclude that the severity of AF fibrosis is associated with the size and functionality of the heart chambers and plays an important role in the development of AF recurrences. Echocardiography is one of the main non-invasive research methods for detecting the presence of atriomegaly, assessing the degree of fibrosis, and settling the issue of the further choice of AF treatment tactics.

Key words: atrial fibrillation, recurrences, echocardiography, left atrium.

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