Advance in the application of 4-dimensional flow MRI in atrial fibrillation

Atrial fibrillation (AF) is the most prevalent arrhythmia in world-wild places and is associated with the development of severe secondary complications such as heart failure and stroke. Emerging evidence shows that the modified hemodynamic environment associated with AF can cause altered flow patterns in left atrial and even systemic blood associated with left atrial appendage thrombosis. Recent advances in magnetic resonance imaging (MRI) allow for the comprehensive visualization and quantification of in vivo aortic flow pattern dynamics. In particular, the technique of 4- dimensional flow MRI (4D flow MRI) offers the opportunity to derive advanced hemodynamic measures such as velocity, vortex, endothelial cell activation potential, and kinetic energy. This review introduces 4D flow MRI for blood flow visualization and quantification of hemodynamic metrics in the setting of AF, with a focus on AF and associated secondary complications. • Atrial fibrillation patients tend to show abnormal hemodynamics compared to healthy controls. • 4D flow MRI can retrospectively analyze flow velocity and other parameters at any location in AF patients • 4D flow MRI has significant value in assessing stroke risk in patients with atrial fibrillation. • More research is needed on the utility of 4D flow MRI in predicting stroke risk in patients with atrial fibrillation.