The role of CT in detecting AF substrate

Trends Cardiovasc Med. 2021 Nov;31(8):457-466. doi: 10.1016/j.tcm.2020.10.004. Epub 2020 Oct 14.

Abstract

Despite technological advancements and evolving ablation strategies, atrial fibrillation catheter ablation outcome remains suboptimal for a cohort of patients. Imaging-based biomarkers have the potential to play a pivotal role in the overall assessment and prognostic stratification of AF patients, allowing for tailored treatments and individualized care. Alongside consolidated evaluation parameters, novel imaging biomarkers that can detect and stage the remodelling process and correlate it to electrophysiological phenomena are emerging. This review aims to provide a better understanding of the different types of atrial substrate, and how Computed Tomography can be used as a pre-ablation risk stratification tool by assessing the various novel imaging biomarkers, providing a valuable insight into the mechanisms that sustain AF and potentially allowing for a patient-specific ablation strategy.

Keywords: AF ablation; AF substrate; Atrial fibrillation.

Publication types

  • Review

MeSH terms

  • Atrial Fibrillation* / diagnostic imaging
  • Atrial Fibrillation* / therapy
  • Catheter Ablation*
  • Heart Atria
  • Humans
  • Recurrence
  • Tomography, X-Ray Computed
  • Treatment Outcome