Related Experiment Video
Updated: Jun 25, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Baseline remodeling-dependent changes in left atrial strain after catheter ablation for paroxysmal atrial
Yuki Hasegawa1, Hiroko Kobayashi2, Minori Sakurazawa3
1Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachidori, Chuo-Ku, Niigata, 951-8510, Japan. yukihasegawa@med.niigata-u.ac.jp.
Background:
Left atrial (LA) mechanical function may change after catheter ablation for atrial fibrillation (AF); however, the determinants of follow-up LA function remain unclear. We aimed to characterize 6-month changes in LA strain and identify baseline determinants of follow-up LA strain after ablation for paroxysmal AF.
Methods:
This prospective study enrolled consecutive patients undergoing first-time pulmonary vein isolation for paroxysmal AF. Two-dimensional speckle-tracking echocardiography from apical four- and two-chamber views was performed at baseline and 6 months to assess LA reservoir strain (LASr) and contraction strain (LASct). Factors associated with 6-month LASr and ΔLASr (6-month minus baseline) were examined using multivariable linear regression.
Results:
Of 167 enrolled patients, 121 without structural heart disease and with analyzable echocardiograms in sinus rhythm at baseline and 6 months were included (67 ± 11 years; 68% men). LASr decreased (25.9 ± 7.9% to 23.1 ± 6.4%, p < 0.001) and LASct declined (11.8 ± 5.5% to 10.4 ± 4.8%, p = 0.007), while LA volume index (LAVI) was unchanged. Baseline LAVI was independently associated with 6-month LASr (standardized β = 0.32, p < 0.001), and higher baseline LAVI was associated with greater ΔLASr (standardized β = 0.33, p < 0.001). These associations were unchanged after adjustment for ablation modality (pulsed-field ablation vs thermal ablation).
Conclusions:
Post-ablation changes in LA strain were continuously associated with baseline LA remodeling; lower baseline LAVI was independently associated with a less favorable change in LASr. Post-ablation LA function should be interpreted in conjunction with baseline remodeling.
