Study of Atrial Fibrillation and Stroke Based on Geometrical and Hemodynamic Characteristics: A Review

The CHA2DS2-VASc score is the most widely used and recognized method for stroke risk stratification in atrial fibrillation (AF) patients. However, some patients with low scores still experience strokes. Given that 90% of cardiogenic strokes are caused by thrombus in the left atrial appendage (LAA), it is essential to incorporate hemodynamic and geometric features of the LAA into existing risk stratification models. This review first evaluates current stroke and bleeding risk stratification strategies, then analyzes the geometric and hemodynamic parameters within the left atrium and LAA, and finally compares the methods and techniques available for acquiring these parameters. Through these retrospective analyses, insights and recommendations for the management of AF patients and stroke prevention are provided. Outlooks on future research directions, such as the exploration of the mechanism of thrombus detachment, are discussed.