Atrial cardiomyopathy represents a process of structural and functional changes affecting the atria and leading eventually to clinical manifestation of atrial fibrillation and risk of stroke. Multimodality imaging provides a comprehensive evaluation of atrial remodeling and plays a crucial role in the decision-making process in treatment strategy. This paper summarizes the current state of knowledge on the topic of left atrial strain imaging using two-dimensional speckle tracking echocardiography (2D-STE). We focus on our recently published data on left atrial remodeling assessed by 2D-STE versus high-density voltage mapping in patients with atrial fibrillation (AF).