Cardiovascular imaging in thromboembolic risk stratification for atrial fibrillation: Recent patents and current practice

Several cardiac diseases, like supra-ventricular arrhythmias, myocardial infarction, left ventricular remodelling with aneurysms and heart valve diseases like mitral valve stenosis, infective endocarditis and prosthetic heart valves predispose to intracavitary thrombus generation, which is the main source for peripheral embolism. Often the main unifying risk factor for cardio-embolism is atrial fibrillation (AF) and many of these cardio-embolic complications are transient ischemic cerebrovascular attacks or strokes with various levels of residual compromise. Cardiac imaging with different techniques and modalities has the potential to effectively stratify thrombo-embolic risk in patients with AF and other cardiac comorbidities. In this review we tried to characterize the current clinical role of different cardiac imaging methods, specifically echocardiography, cardiac computed tomography and cardiovascular magnetic resonance, in identifying cardio-embolic risk factors and guiding antithrombotic therapy, with a particular attention to novel patents and future developments of these techniques.