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Left Atrial Structural and Functional Changes After Pulmonary Vein Isolation Using Different Energy Sources.

Jonasz Kozielski1, Monika Olczyk1, Ewa Świerżyńska-Wodarska2

  • 1Department of Cardiology and Interventional Angiology, Kashubian Center for Heart and Vascular Diseases, Pomeranian Hospitals, 84-200 Wejherowo, Poland.

Sensors (Basel, Switzerland)
|July 15, 2026
PubMed
Summary

Cryoballoon ablation (CBA) may lead to greater left atrial (LA) structural remodeling than radiofrequency catheter ablation (RFCA) after pulmonary vein isolation (PVI) for atrial fibrillation (AF). Further research is needed to confirm these preliminary findings.

Keywords:
atrial fibrillationcatheter ablationechocardiography

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Imaging

Background:

  • Pulmonary vein isolation (PVI) is a standard treatment for atrial fibrillation (AF).
  • The long-term effects of different PVI techniques on left atrial (LA) remodeling remain unclear.
  • Assessing structural and functional changes in the LA post-PVI is crucial for understanding treatment efficacy.

Purpose of the Study:

  • To compare the impact of cryoballoon ablation (CBA) versus radiofrequency catheter ablation (RFCA) on LA structure and function.
  • To evaluate changes in LA size, volume, and mechanical properties 12 months after PVI.
  • To investigate potential differences in LA remodeling between CBA and RFCA.

Main Methods:

  • Prospective analysis of 42 patients undergoing PVI (28 CBA, 14 RFCA).
  • Transthoracic echocardiography with speckle-tracking analysis performed pre-ablation and at 12-month follow-up.
  • Assessment of LA dimensions, volumetric indices (LAVI), and strain parameters (LAS-R).

Main Results:

  • Cryoballoon ablation (CBA) group showed a trend towards greater increases in LA diameter and LA appendage strain (LAS-R) compared to radiofrequency catheter ablation (RFCA).
  • A significant group-by-time interaction was observed for LA diameter (p=0.0017) and trends for LAA (p=0.0645) and LAS-R (p=0.0547).
  • No significant differences in LAVI-derived parameters or other LA mechanical function indices were found between groups.

Conclusions:

  • Cryoballoon ablation (CBA) may be associated with more pronounced structural left atrial (LA) remodeling compared to radiofrequency catheter ablation (RFCA) at 12-month follow-up.
  • These findings are preliminary due to limited sample size and patient heterogeneity.
  • Larger prospective studies are required to validate the observed differences in LA remodeling post-PVI.