The role of echocardiography in atrial fibrillation and cardioversion.

Correspondence to: Allan L Klein MD, Cleveland Clinic Foundation, Department of Cardiovascular Medicine, 9500 Euclid Avenue, Desk F15, Cleveland, OH 44195, USA; [email protected] _________________________ A trial fibrillation (AF) is the most commonly encountered arrhythmia in clinical practice. Recent advances in technology and in the understanding of the pathophysiology of AF have led to more definitive and potentially curative therapeutic approaches. In this setting, 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. In this review, we highlight the echocardiographic modalities that are available and their role in the evaluation and management of AF.