Multimodale beeldvorming verheldert atriumfibrilleren bij infiltratieve cardiomyopathieën

Infiltrative cardiomyopathies comprise a heterogeneous spectrum of hereditary and acquired diseases characterised by the accumulation of pathological substrates within the myocardium, ultimately resulting in progressive impairment of cardiac function and the development of heart failure. Across these conditions, atrial fibrillation is a frequent and clinically relevant complication, contributing to symptom burden, heart failure progression, and thromboembolic risk. Structural, functional, and electrical atrial remodelling, collectively referred to as atrial cardiomyopathy, emerges as a common pathophysiological substrate linking myocardial infiltration to atrial fibrillation and adverse cardiovascular outcomes. Multi-modality cardiac imaging enables comprehensive assessment of atrial cardiomyopathy, offering mechanistic insights into the atrial substrate of atrial fibrillation, with potential impact on the clinical management of this group of diseases. This review summarises contemporary evidence on atrial fibrillation in infiltrative cardiomyopathies, with a particular focus on the role of non-invasive multimodal imaging in the evaluation of atrial cardiomyopathy.