Unraveling Atrial Myopathy

Atrial fibrillation (AF) is the most common arrhythmia encountered, especially in elderly. AF leads to fivefold risk of stroke. However, there is a no temporal association found when we compare the onset of AF and stroke suggesting that the presence of AF is not mandatory for stroke occurrence. This has led to concept of atrial myopathy suggesting that a diseased atrium can provoke stroke without AF. Atrial interstitial fibrosis, inflammation, and extracellular matrix deposition can initiate and perpetuate atrial myopathy leading to stasis of blood flowing through the atria and may lead to stroke without intervening AF. AF may be just a marker of atrial myopathy. The present paper reviews the emerging concept of atrial myopathy, its pathogenesis, precursors, and diagnosis.