The term “atrial remodeling” is used to describe the electrical, mechanical, and structural changes associated with the presence of an arrhythmogenic substrate for atrial fibrillation. Rhythm control therapy may slow down or even reverse progressive atrial remodeling. Atrial remodeling has long been recognized as an important predictor of clinical outcomes and therapeutic success, but recent advances have highlighted its clinical relevance and revealed the implications of specific anatomical changes such as atrial asymmetry or shape. This has opened the path to computational precision medicine that captures these data in detail and combines them with other factors, to provide patient-specific solutions. The goal of precision medicine lies in improving clinical outcomes, reducing costs, and avoiding unnecessary procedures. In this article, we review the history of atrial remodeling and we summarize the insights from our research on anatomical atrial remodeling and its association with rhythm outcomes after catheter ablation. Finally, we present recent advances in the field, reflecting the beginning of a new technological era that will enable us to improve patient care by personalized patient-specific medicine.

术语“心房重构”用于描述与心房颤动的致心律失常基质的存在相关的电、机械和结构变化。节律控制疗法可能会减慢甚至逆转进行性心房重构。心房重塑长期以来被认为是临床结果和治疗成功的重要预测因素，但最近的进展突出了其临床相关性，并揭示了特定解剖结构变化（如心房不对称或形状）的影响。这为计算精准医学开辟了道路，可以详细捕获这些数据并将它们与其他因素结合起来，以提供针对患者的解决方案。精准医学的目标在于改善临床结果、降低成本和避免不必要的程序。在本文中，我们回顾了心房重构的历史，并总结了我们对解剖心房重构及其与导管消融后心律结果的关联的研究的见解。最后，我们介绍了该领域的最新进展，反映了一个新的技术时代的开始，它将使我们能够通过个性化的针对患者的医疗来改善患者护理。