Arrhythmias & electrophysiology
Impact of Left Atrial Dilatation on Catheter Ablation Outcomes for Persistent Atrial Fibrillation: Does Size Matter?
Authors' conclusion
In persistent AF, baseline LAVI did not predict arrhythmia recurrence after first-time ablation but was associated with higher AF burden and persistent recurrence phenotype at 1 year postablation. These findings suggest that LA size may influence recurrence burden and phenotype rather than overall ablation success.
Study context
- Population
- Patients with persistent atrial fibrillation (AF) undergoing catheter ablation, screened for pre-ablation LA volume index (LAVI) evaluation on echocardiography281 (83.1%) had baseline LAVI data available
- Participants
- 338 patients
- Comparison
- Baseline LAVI and arrhythmia recurrence, burden and recurrence phenotype after ablation
- Outcome
- Arrhythmia recurrence
- Follow-up
- 1 year and 3 years
Main finding
As reported in the abstract
Recurrence at 1 year
130
46.3%
Recurrence at 3 years
173
61.6%
Further findings
Association of LAVI with arrhythmia recurrence
| OR (95% CI) | P value | ||
|---|---|---|---|
| LAVIMultivariable analysis | 1.01 (0.99–1.02) | P = 0.55 | |
| 0.512Odds ratio (log scale) |
| Outcome | OR (per 10 mL/m²) (95% CI) | P value | |
|---|---|---|---|
| Persistent (vs paroxysmal) recurrence among patients with arrhythmia recurrence · 12 monthsPersistentvs paroxysmal recurrenceAmong patients with arrhythmia recurrence | 1.78 (1.33–2.47) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
- Association of LAVI with arrhythmia recurrence — Stratified by LAVI category (log-rank test)
- P = 0.19
Arrhythmia burden among patients with arrhythmia recurrence · 12 months
- Increased LAVI associated with greater arrhythmia burden, R2
- 0.12
- P
- P < 0.001
- Among patients with arrhythmia recurrence
Original publication
Impact of Left Atrial Dilatation on Catheter Ablation Outcomes for Persistent Atrial Fibrillation: Does Size Matter? JACC Clin Electrophysiol. Published 21 May 2026. doi:10.
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