This link has been most thoroughly investigated regarding the thromboembolic risk associated with AF.61 Among patients with AF, the extent of left atrial fibrosis as measured by cardiac magnetic resonance imaging, is strongly associated with the risk of stroke.62,63 The addition of blood biomarkers of myocyte injury and stretch, such as troponin and brain natriuretic peptide, as well as electrocardiographic markers of atrial remodelling, adds incremental value for stroke risk prediction in patients with AF64–67 (Figure 3). This evidence concerns the gene NPPB and atrial fibrillation.