Echocardiography and Atrial fibrillation

This post is about echocardiography and its application in atrial fibrillation

An echocardiogram (echo) is a test that uses high frequency sound waves (ultrasound) to make pictures of your heart. The test is also called echocardiography or diagnostic cardiac ultrasound. An echo uses sound waves to create pictures of the heart’s chambers, valves, walls and the blood vessels (aorta, arteries, veins) attached to the heart. A probe called a transducer is passed over the chest. The probe produces sound waves that bounce off the heart and “echo” back to the probe. These waves are changed into pictures viewed on a video monitor. An echo can’t harm the patient Echocardiography is used to monitor heart valve disease over time, to check any abnormality in heart and to see the progress of medical or surgical intervention.

This is a visualization of transthoracic echo data in ITK-snap

transthoracic echocardiogram (TTE) is the most common type of echocardiogram, which is a still or moving image of the internal parts of the heart using ultrasound. In this case, it is placed on the chest or abdomen of the subject to get various views of the heart. It is used as a non-invasive assessment of the overall health of the heart, including a patient’s heart valves and degree of heart muscle contraction (an indicator of the ejection fraction). The images are displayed on a monitor for real-time viewing and then recorded. Echocardiography provides crucial information for predicting ventricular remodeling and functional recovery, LV size and volume, regional wall motion abnormality, myocardial viability, LV filling pressures, severity of mitral regurgitation, and systolic pulmonary artery pressure.

Atrial fibrillation (AF) is the most commonly encountered arrhythmia in clinical practice.  AF frequently accompanies common conditions such as hypertension, chronic heart failure, and valvar or ischaemic heart disease, and is an important sequela of cardiothoracic surgery. Echocardiography has a unique and important role in the assessment of cardiac structure and function, risk stratification, and increasingly in guiding the management of AF. Because of its recognised value, echocardiography has become established in guidelines for management of AF and utilisation of echocardiography has increased, particularly of transoesophageal echocardiography to guide direct current cardioversion or detect cardiac sources of embolism. Even more recently 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. Transthoracic echocardiography readily identifies important underlying conditions that predispose to AF, including left ventricular systolic dysfunction caused by dilated cardiomyopathy, left ventricular hypertrophy caused by hypertension, valvar heart disease particularly rheumatic mitral stenosis or pericardial disease.

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