Left Atrial Remodeling

Left atrial remodeling

Left atrial remodeling has mainly three aspects – electrical, functional and structural. Others aspects are ionic and molecular remodeling. Electrical remodeling can be assessed by the interval between the onset of P wave on the ECG and A’ on the tissue Doppler evaluation. Left atrial appendage velocity determined by Doppler interrogation gives an idea about left atrial functional remodeling. Structural remodeling can be assessed by echocardiographically derived left atrial volume index.

Ionic and molecular remodeling are difficult to assess clinically and are meant for in vitro studies. Remodeling forms the basis of atrial cardiomyopathy with complex structural, architectural, contractile and electrophysiological changes of the atria [1]. Left atrial remodeling has an important role in the perpetuation of atrial fibrillation and conversion of paroxysmal atrial fibrillation to a persistent one.

Reference

1. Andreas Goette, Jonathan M Kalman, Luis Aguinaga, Joseph Akar, Jose Angel Cabrera, Shih Ann Chen, Sumeet S Chugh, Domenico Corradi, Andre D’Avila, Dobromir Dobrev, Guilherme Fenelon, Mario Gonzalez, Stephane N Hatem, Robert Helm, Gerhard Hindricks, Siew Yen Ho, Brian Hoit, Jose Jalife, Young-Hoon Kim, Gregory Y H Lip, Chang-Sheng Ma, Gregory M Marcus, Katherine Murray, Akihiko Nogami, Prashanthan Sanders, William Uribe, David R Van Wagoner, Stanley Nattel. EHRA/HRS/APHRS/SOLAECE Expert Consensus on Atrial Cardiomyopathies: Definition, Characterization, and Clinical Implication. Heart Rhythm. 2017 Jan;14(1):e3-e40.