Related Experiment Video
Updated: Apr 27, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
The effect of ablation for paroxysmal atrial fibrillation on left atrial volume and function: a one-year follow-up
Jung Yeon Chin1, Ho-Joong Youn2
1Division of Cardiology, Eulji University School of Medicine, Daejeon, Korea.
Insights
Radiofrequency catheter ablation for paroxysmal atrial fibrillation reduces left atrial volume and function initially. Long-term, function stabilizes in successful ablations but worsens with AF recurrence.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Imaging
Background:
- Left atrial (LA) volume and function changes after radiofrequency catheter ablation (RFCA) for paroxysmal atrial fibrillation (PAF) require further investigation.
- Understanding these long-term effects is crucial for managing patients with PAF.
Purpose of the Study:
- To evaluate the long-term impact of RFCA on LA volume and function in patients with drug-refractory PAF.
- To assess changes in LA volume index, LA ejection fraction (LAEF), and LA active emptying fraction (LAAEF) over one year post-ablation.
Main Methods:
- Ninety patients with drug-refractory PAF in sinus rhythm at baseline underwent echocardiography.
- Measurements of LA volume index, LAEF, and LAAEF were taken at baseline, 3 months, and 1 year post-RFCA.
- Patients were categorized based on AF recurrence at the 1-year follow-up.
Main Results:
- After 3 months, LA maximal volume index decreased significantly (p<0.001), while LAEF and LAAEF also showed significant reductions (p<0.001).
- At 1 year, LA volumes and function remained stable compared to 3 months in patients without AF recurrence.
- In patients with AF recurrence, LA function significantly worsened between 3 months and 1 year (p=0.026 for LAEF, p=0.012 for LAAEF).
Conclusions:
- Successful RFCA for PAF leads to an initial decrease in LA volume and function.
- LA volume and function remain stable at one year in patients without AF recurrence post-ablation.
- Patients experiencing AF recurrence demonstrate a significant worsening of LA function at one year.
Purpose:
The effect of radiofrequency catheter ablation (RFCA) on left atrial (LA) volume and function in patients with paroxysmal atrial fibrillation (PAF) has not been extensively studied. The aim of this study was to evaluate the long-term impact of RFCA on LA volume and function in patients with PAF.
Materials And Methods:
A total of 90 patients with drug-refractory PAF who had sinus rhythm on the initial echocardiogram were examined at baseline, 3 months and 1 year after ablation. We measured LA volume index, LA ejection fraction (LAEF; maximal-minimal LA volume/maximal LA volume), and LA active emptying fraction (LAAEF; mid-diastolic-minimal LA volume/mid-diastolic LA volume).
Results:
After 12±1 months, 78 patients returned, and 61 patients (78%) had sinus rhythm. After 3 months, the LA maximal volume indices decreased (from 33±13 to 28±12 mL/m²; p<0.001). But, LAEF and LAAEF also decreased (from 48±13 to 39±12; p<0.001, from 27±13 to 19±11; p<0.001). After 1 year, LA volumes, LAEF, and LAAEF remained similar at 3 months. In patients without atrial fibrillation (AF) recurrence, LAEF and LAAEF decreased after 3 months (from 50±12 to 40±11; p<0.001, from 29±13 to 22±11; p<0.001) and did not change after 1 year. However, in patients with AF recurrence, those who did not have decreased levels after 3 months had significantly decreased after 1 year (from 43±14 to 34±11; p=0.026, from 22±12 to 15±10; p=0.012).
Conclusion:
Successful RFCA of PAF decreased LA volume and function at 3 months. At one year, LA volume and function was remained unchanged in successfully ablated patients whereas LA function in patients with AF recurrence worsened.
