Left Atrial Mechanical and Hemodynamic Function After Ablation of Atrial Fibrillation

Atrial fibrillation (AF) is the most common sustained arrhythmia, with pulmonary vein isolation (PVI) established as the gold standard of interventional therapy. A key challenge remains the impact of ablation procedures on the mechanics and hemodynamics of the left atrium (LA), whose remodeling plays a crucial role in prognosis, AF recurrence, and complications such as stiff left atrial syndrome (SLAS). This review summarizes current evidence on structural and functional LA assessment using electrocardiography, echocardiography, computed tomography, and cardiac magnetic resonance imaging, with particular emphasis on the prognostic value of imaging and electrophysiological parameters. The effects of different ablation strategies-including radiofrequency catheter ablation (RFCA), cryoballoon ablation (CBA), pulsed field ablation (PFA), and surgical techniques-on LA remodeling, mechanical performance, and long-term outcomes are discussed. Both beneficial effects, such as reductions in LA volume and improved contractility, and adverse consequences, such as scaring and impaired compliance, are highlighted.