Baseline remodeling-dependent changes in left atrial strain after catheter ablation for paroxysmal atrial fibrillation.

Authors

Yuki Hasegawa, Hiroko Kobayashi, Minori Sakurazawa, Hironori Furuse, Yuka Sekiya, Rie Akagawa, Naomasa Suzuki, Yasuhiro Ikami, Sou Otsuki, Takeshi Kashimura, Masaomi Chinushi, Takayuki Inomata

Published in

Journal of echocardiography. Jun 24, 2026. Epub Jun 24, 2026.

Abstract

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.
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.
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).
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.

PMID:
42340641
Bibliographic data and abstract were imported from PubMed on 24 Jun 2026.

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