Physiological assessment of stroke risk in atrial fibrillation using 4D-flow with cardiac magnetic resonance imaging

Susil Pallikadavath
15/04/2025

Take home messages

  • Stroke is the major cause of a loss in quality of life associated with atrial fibrillation.
  • Internationally utilised risk scores such as CHA2-DS2-Vasc have limited predictive capacity.
  • Physiological assessment of the left atrium using 4D-flow cardiac magnetic resonance is a promising advance in assessing intracardiac flow and thromboembolism risk.

Atrial fibrillation is the most common cardiac arrhythmia in the United Kingdom with a point prevalence of 2.5%. The diagnosis of AF is associated with a five-fold increase in the risk of stroke. These strokes are often more severe and confer a greater loss in quality of life when compared to non-AF strokes. Anticoagulation is offered to individuals deemed to be at a high risk of stroke, using internationally recognised risk scores such as CHA2-DS2-Vasc (now CHA2-DS2-VA), and reduces the risk of stroke by up to two-thirds.