Atrial fibrillation (AF) is one of the arrhythmias with the highest socioeconomic burden and acts as an accelerant for other cardiac dysfunctions1. AF can be considered a progressive disease in all respects and can lead over time to tachycardia-mediated cardiomyopathy, characterised by reduced left ventricular ejection fraction (LVEF) and congestive heart failure. However, many patients with AF present with symptoms of dyspnoea but have a normal LVEF.
Left ventricular (LV) myocardial strain is a measure of ventricular performance that has been shown to accurately assess LV myocardial contractility and is commonly evaluated by echocardiography2; but the role of cardiac magnetic resonance (CMR) in strain assessment is emerging in the literature3, given the intrinsic advantages of CMR, primarily tissue characterisation.
The purpose of this study is to use CMR to assess ventricular strain in a group of patients with AF on oral anticoagulant therapy and to evaluate whether it may be a more sensitive marker of cardiac impairment in this patient group.