Related Experiment Video
Updated: May 26, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
The impact of atrial fibrillation ablation on left atrial function: association with baseline left atrial function
Masaharu Masuda1, Koichi Inoue, Katsuomi Iwakura
1Sakurabashi Watanabe Hospital, Kita-ku, Osaka, Japan.
Insights
Atrial fibrillation (AF) ablation improved left atrial (LA) function in patients with baseline impairment. However, older patients with preserved LA function may experience reduced LA function post-ablation.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Imaging
Background:
- The impact of atrial fibrillation (AF) ablation on left atrial (LA) function requires further elucidation.
- Understanding these effects is crucial for optimizing patient management and outcomes.
Purpose of the Study:
- To determine the effect of AF ablation on left atrial (LA) volume and function.
- To identify predictors of LA function changes after AF ablation.
Main Methods:
- 115 patients with AF undergoing ablation were evaluated using multidetector computed tomography.
- LA volume and function, including LA emptying fraction (LAEF), were assessed before and 3 months post-ablation.
- Statistical analyses identified factors associated with LA function improvement or deterioration.
Main Results:
- AF ablation led to a significant decrease in maximum LA volume but maintained LA emptying fraction (LAEF).
- Larger baseline LA volume correlated with a greater LA volume decrease post-ablation.
- Impaired baseline LAEF predicted LA function improvement, while older age and preserved baseline LAEF predicted deterioration.
Conclusions:
- AF ablation may benefit LA function in patients with baseline impairment.
- Conversely, AF ablation might reduce LA function in older individuals with already preserved LA function.
Background:
The effect of atrial fibrillation (AF) ablation on left atrial (LA) function has not been sufficiently determined.
Methods:
We enrolled 115 consecutive patients with paroxysmal or persistent AF that underwent AF ablation. Multidetector computed tomography was performed in sinus rhythm before and 3 months after ablation to evaluate LA volume (LAV) and function. Estimates of maximum and minimum LAV were used to calculate LA emptying fraction (LAEF) ([maximum-minimum LAV]/maximum LAV × 100).
Results:
AF ablation significantly decreased maximum LAV (59.0 ± 20.4 to 53.3 ± 16.7 cm(3) , P = 0.001), and maintained LAEF (44.5 ± 13.1% to 43.7 ± 10.9%, P = 0.49). The larger the baseline maximum LAV, the greater the decrease in LAV after ablation, and a smaller baseline LAEF was associated with a larger recovery of LAEF after ablation (regression coefficient =-0.45 and -0.56, respectively, P < 0.0001). Multivariable analyses revealed that an impaired baseline LAEF was an independent predictor of an improvement in LA function (an increase in LAEF of >10%; odds ratio [OR] = 0.88, P < 0.0001), while an older age and preserved baseline LAEF were independently associated with a deterioration of LA function (a decrease in LAEF of >10%; OR = 1.06, P = 0.03; and OR = 1.10, P = 0.0001).
Conclusions:
AF ablation appears to have a beneficial effect on LA function in patients with impaired LA function at baseline. However, it may reduce LA function in patients with an older age and preserved baseline LAEF.
