EACVI/EHRA Expert Consensus Document on the role of multi-modality imaging for the evaluation of patients with atrial fibrillation

TLDR

Atrial fibrillation is the most common cardiac rhythm disorder, and while ECG is essential for evaluation, the clinical value of imaging modalities such as echocardiography, CMR, CT, and nuclear imaging for guiding management remains uncertain. The consensus document examines how left atrial volume and strain measured by echocardiography, left atrial fibrosis assessed by CMR, and CT imaging can inform management and procedural planning in AF patients. The consensus was developed by the European Association of Cardiovascular Imaging and the European Heart Rhythm Association, outlining imaging approaches for AF. Fourteen consensus statements were issued, providing guidance for imagers and electrophysiologists on selecting and interpreting imaging techniques, particularly highlighting CT’s role in procedural planning.

Abstract

Atrial fibrillation (AF) is the commonest cardiac rhythm disorder. Evaluation of patients with AF requires an electrocardiogram, but imaging techniques should be considered for defining management and driving treatment. The present document is an expert consensus from the European Association of Cardiovascular Imaging (EACVI) and the European Heart Rhythm Association. The clinical value of echocardiography, cardiac magnetic resonance (CMR), computed tomography (CT), and nuclear imaging in AF patients are challenged. Left atrial (LA) volume and strain in echocardiography as well as assessment of LA fibrosis in CMR are discussed. The value of CT, especially in planning interventions, is highlighted. Fourteen consensus statements have been reached. These may serve as a guide for both imagers and electrophysiologists for best selecting the imaging technique and for best interpreting its results in AF patients.