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STATE-OF-THE-ART PAPER

Cardiovascular Imaging in the Management of Atrial Fibrillation

Oussama M. Wazni, MD^_*, Hsuan-Ming Tsao, MD^,, Shih-Ann Chen, MD, Hsuan-Hung Chuang, MBBS^_*, Walid Saliba, MD^_*, Andrea Natale, MD^_*,_* and Allan L. Klein, MD^_*

^_* Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
Taipei Veterans General Hospital, Taipei, Taiwan
I-Lan Hospital, Taipei, Taiwan
The Division of Cardiology and Cardiovascular Research Center, National Yang-Ming University, School of Medicine, Taipei, Taiwan.

Manuscript received March 1, 2006; revised manuscript received May 31, 2006, accepted June 6, 2006.

^_* Reprint requests and correspondence: Dr. Andrea Natale, Head, Section of Pacing and Electrophysiology, Director, Electrophysiology Laboratory, Co-Director, Center for Atrial Fibrillation, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Desk F 15, 9500 Euclid Avenue, Cleveland, Ohio 44195. (Email: natalea{at}ccf.org).

Atrial fibrillation (AF) is he most commonly encountered arrhythmia in clinical practice, with an overall prevalence of 0.4% in the general population. Recent advances in technology and in the understanding of the pathophysiology of AF have led to more definitive and potentially curative therapeutic approaches. Echocardiography has a well-established role in the assessment of cardiac structure and function and risk stratification, and has become an essential part of the guidelines for management of AF. The development of intracardiac echocardiography has led to real-time guidance of percutaneous interventions, including radiofrequency ablation and left atrial appendage closure procedures for patients with AF. Other imaging modalities, including computed tomography and magnetic resonance angiography, have allowed for more accurate measurement and better understanding of the cardiac anatomy. We review the impact of various imaging modalities in the evaluation and management of AF.

Abbreviations and Acronyms   AF = atrial fibrillation   CT = computed tomography   ICE = intracardiac echocardiography   LA = left atrium   LAA = left atrial appendage   LV = left ventricular   MDCT = multidetector computed tomography   MRA = magnetic resonance angiography   NSR = normal sinus rhythm   PV = pulmonary vein   RF = radiofrequency   SEC = spontaneous echo contrast   TEE = transesophageal echocardiography

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