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Updated: Jan 19, 2026

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

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Left atrial structure and function predictors of recurrent fibrillation after catheter ablation: a systematic review

Gani Bajraktari1,2,3, Ibadete Bytyçi1,2, Michael Y Henein1,4,5

  • 1Institute of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

Clinical Physiology and Functional Imaging
|September 27, 2019
PubMed

Insights

Catheter ablation for atrial fibrillation (AF) has high recurrence. Left atrial (LA) dilation (diameter >50mm, volume >150ml) or low LA strain (<19%) predicts AF recurrence post-ablation, indicating an unstable LA.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Imaging

Background:

  • Catheter ablation (CA) is a standard treatment for atrial fibrillation (AF).
  • High recurrence rates persist after CA for AF.
  • Predictors of AF recurrence after CA require identification.

Purpose of the Study:

  • To identify left atrial (LA) structure and function indices predicting AF recurrence post-CA.
  • To conduct a meta-analysis of existing studies on echocardiographic predictors of AF recurrence.

Main Methods:

  • Systematic literature search of PubMed-Medline, EMBASE, Scopus, Google Scholar, and Cochrane Central Registry up to September 2017.
  • Inclusion of 85 clinical trials and observational studies encompassing 16,126 patients.
  • Pooled analysis of echocardiographic data to determine significant predictors of AF recurrence.

Main Results:

  • Patients with AF recurrence exhibited larger LA diameter, LA volume index (LAVI), and LA area compared to those without recurrence.
  • Lower LA strain and LA total emptying fraction (LA EF) were observed in patients with AF recurrence.
  • Key predictors of AF recurrence included LA strain <19%, LA diameter ≥50 mm, and LAVmax >150 ml.

Conclusions:

  • A dilated left atrium (diameter >50 mm, volume >150 ml) suggests instability.
  • Reduced left atrial myocardial strain (<19%) indicates an unstable LA.
  • These factors predict a lower likelihood of maintaining sinus rhythm after catheter ablation for atrial fibrillation.
Abstract

Keywords:
atrial fibrillationcatheter ablationleft atriumpredictorsrecurrences

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