Arrhythmias & electrophysiologyResearch article
Impact of Left Atrial Dilatation on Catheter Ablation Outcomes for Persistent Atrial Fibrillation
- Analysis of patients enrolled in the CAPLA trial
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
Main finding
As reported in the abstract
Arrhythmia recurrence · 1 year and 3 years
Recurrence at 1 year
130 (46.3%)
Recurrence at 3 years
173 (61.6%)
Further findings
Association of LAVI with arrhythmia recurrence
| Comparison | OR (95% CI) | P value | |
|---|---|---|---|
| LAVI · multivariable 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 months · persistent vs paroxysmal recurrence · among 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. JACC Clin Electrophysiol. Published 21 May 2026. doi:10.1016/j.jacep.2026.04.019
Summarised from the published abstract; every number is checked against it