Alterations in left atrial volume and function after atrial fibrillation ablation evaluated by three-dimensional...

Left atrial (LA) strain, measured using speckle-tracking echocardiography (STE), is crucial for evaluating LA performance. However, alterations in longitudinal and circumferential LA reservoir function after atrial fibrillation (AF) ablation remain undefined. We aimed to examine acute changes in two-directional LA reservoir function and their relationship to those in LA volume before and after AF ablation. We quantified the maximum LA volume index (LAVImax) and longitudinal (LASr) and circumferential (LASrc) reservoir strain using 3D-STE in 80 patients (45 males) before ablation and 1 day/3 months after ablation for AF (n = 46, paroxysmal atrial fibrillation (PAF); n = 34, non-PAF). LAVImax negatively correlated with left ventricular ejection fraction (LVEF, p < 0.001), LASr (p < 0.001), and LASrc (p < 0.001) before ablation. One day after ablation, LASr (p = 0.001) decreased significantly in patients with PAF, accompanied by reduced LVEF (p = 0.043) without changes in LAVImax. In patients with non-PAF, recovery in LASrc (42 ± 82%, p = 0.006) was significant compared to LASr (11 ± 60%, p = 0.296), with a reduction in LAVImax (-8 ± 20%, p = 0.049). Delta changes in LAVImax at one day after ablation correlated with those in LASrc in patients with PAF (r = 0.323, p = 0.039) and non-PAF (r = 0.542, p = 0.003). In conclusions, acute LA reservoir strain changes detected post-ablation differed in direction between patients with PAF and those with non-PAF. Alterations in LA volume correlated well with those in the circumferential reservoir strain in both PAF and non-PAF.