5.3 Benefit of non-invasive imaging
Function of LAA is difficult to measure and transesophageal echocardiography is virtually only available option. Although abnormal LAA function is a known risk factor for ischemic stroke in AF patients, it is not incorporated into CHA2DS2-VASc scoring system.4-8, 22 Main reason is that transesophageal echocardiography (i) is an invasive imaging test; (ii) has rare but serious complications such as esophageal injury; (iii) is associated with patient discomfort related with the insertion of the probe usually requiring sedatives; and (iv) requires well trained cardiologist to perform and therefore is not an anytime available test. Recent studies revealed that LAA flow volume measured with VENC-MRI can reliably predict LAA hemodynamics.9, 10 Since VENC-MRI is a non-invasive imaging test that do not require inconvenient probe insertion, it has a potential for disseminated use. The role of VENC-MRI in the prediction of ischemic stroke and assessing the result of RFCA in AF patients warrants large randomized clinical trials.