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Abstract

Atrial fibrillation (AF) is the most common arrhythmia and has been long recognized as a cause for atrial thrombus formation leading to cardioembolic stroke. However, recent studies reveal that the relationship between atrial fibrillation and stroke is an association rather than a temporal relationship. Left atrial thrombus formation is associated with vascular risk factor, atrial remodeling, and thrombogenesis. Various atrial electrical and structural markers of atrial myopathy have been linked to ischaemic stroke, even in the absence of AF. In addition to the CHA2DS2-VASc score as a consideration for anticoagulant administration, accurate atrial myopathy markers are needed to allow early identification of patients at risk for cardioembolic stroke. This article describes the current concept of atrial myopathy, including its pathophysiology, diagnostic approach, and stroke prevention.

Bahasa Abstract

Fibrilasi atrium (FA) merupakan aritmia yang paling sering terjadi dan telah lama dianggap sebagai penyebab terbentuknya trombus atrial yang dapat menyebabkan stroke kardioembolik. Namun, sejumlah penelitian terbaru menunjukkan  bahwa hubungan antara fibrilasi atrium dengan stroke merupakan suatu asosiasi dan bukan hubungan sebab-akibat. Pembentukan trombus atrium kiri secara kompleks berhubungan dengan faktor risiko vaskular, remodeling atrium, dan trombogenesis. Berbagai penanda elektrikal dan struktural atrium kiri pada pasien miopati atrium tanpa irama FA telah dikaitkan dengan kejadian stroke iskemik. Selain skor CHA2DS2-VASc sebagai pertimbangan pemberian antikoagulan, diperlukan penanda miopati atrium yang akurat agar identifikasi dini dapat dilakukan pada pasien yang berisiko mengalami stroke kardioembolik. Artikel ini menjelaskan konsep terkini miopati atrium yang berfokus pada patofisiologi, pendekatan diagnostik, dan pencegahan stroke.

Kata Kunci: fibrilasi atrium, miopati atrium, stroke, trombogenesis

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