IMR Press / RCM / Volume 23 / Issue 5 / DOI: 10.31083/j.rcm2305171
Open Access Review
From Left Atrial Dimension to Curved M-Mode Speckle-Tracking Images: Role of Echocardiography in Evaluating Patients with Atrial Fibrillation
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1 Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou branch, 33304 Taoyuan, Taiwan
2 Department of Anesthesia, Chang Gung Memorial Hospital, Taipei branch, 10507 Taipei, Taiwan
3 School of Medicine, Chang Gung University College of Medicine, 33302 Taoyuan, Taiwan
*Correspondence: (Chung-Chuan Chou)
Academic Editor: Buddhadeb Dawn
Rev. Cardiovasc. Med. 2022, 23(5), 171;
Submitted: 10 February 2022 | Revised: 16 March 2022 | Accepted: 24 March 2022 | Published: 11 May 2022
(This article belongs to the Special Issue Role of Echocardiography in Current Cardiology Practice)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Left atrial (LA) enlargement and dysfunction increase the risk of atrial fibrillation (AF). Traditional echocardiographic evaluation of the left atrium has been limited to dimensional and semi-quantification measurement of the atrial component of ventricular filling, with routine measurement of LA function not yet implemented. However, functional parameters, such as LA emptying fraction (LAEF), may be more sensitive markers for detecting AF-related changes than LA enlargement. Speckle-tracking echocardiography has proven to be a feasible and reproducible technology for the direct evaluation of LA function. The clinical application, advantages, and limitations of LA strain and strain rate need to be fully understood. Furthermore, the prognostic value and utility of this technique in making therapeutic decisions for patients with AF need further elucidation. Deep learning neural networks have been successfully adapted to specific tasks in echocardiographic image analysis, and fully automated measurements based on artificial intelligence could facilitate the clinical diagnostic use of LA speckle-tracking images for classification of AF ablation outcome. This review describes the fundamental concepts and a brief overview of the prognostic utility of LA size, LAEF, LA strain and strain rate analyses, and the clinical implications of the use of these measures.

atrial fibrillation
catheter ablation
left atrial enlargement
left atrial emptying fraction
deep learning neural networks
Fig. 1.
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