title: The impact of atrial fibrillation ablation on left atrial function: association with baseline left atrial function.
abstract: BACKGROUND
  The effect of atrial fibrillation (AF) ablation on left atrial (LA) function has not been sufficiently determined.
  
  
  METHODS
  We enrolled 115 consecutive patients with paroxysmal or persistent AF that underwent AF ablation. Multidetector computed tomography was performed in sinus rhythm before and 3 months after ablation to evaluate LA volume (LAV) and function. Estimates of maximum and minimum LAV were used to calculate LA emptying fraction (LAEF) ([maximum-minimum LAV]/maximum LAV × 100).
  
  
  RESULTS
  AF ablation significantly decreased maximum LAV (59.0 ± 20.4 to 53.3 ± 16.7 cm(3) , P = 0.001), and maintained LAEF (44.5 ± 13.1% to 43.7 ± 10.9%, P = 0.49). The larger the baseline maximum LAV, the greater the decrease in LAV after ablation, and a smaller baseline LAEF was associated with a larger recovery of LAEF after ablation (regression coefficient =-0.45 and -0.56, respectively, P < 0.0001). Multivariable analyses revealed that an impaired baseline LAEF was an independent predictor of an improvement in LA function (an increase in LAEF of >10%; odds ratio [OR] = 0.88, P < 0.0001), while an older age and preserved baseline LAEF were independently associated with a deterioration of LA function (a decrease in LAEF of >10%; OR = 1.06, P = 0.03; and OR = 1.10, P = 0.0001).
  
  
  CONCLUSIONS
  AF ablation appears to have a beneficial effect on LA function in patients with impaired LA function at baseline. However, it may reduce LA function in patients with an older age and preserved baseline LAEF.
authors.affiliation: Sakurabashi Watanabe Hospital, Kita-ku, Osaka, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Masuda
authors.forename: Koichi
authors.initials: K
authors.lastname: Inoue
authors.forename: Katsuomi
authors.initials: K
authors.lastname: Iwakura
authors.forename: Atsunori
authors.initials: A
authors.lastname: Okamura
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Koyama
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Kimura
authors.forename: Yuko
authors.initials: Y
authors.lastname: Toyoshima
authors.forename: Norihisa
authors.initials: N
authors.lastname: Ito
authors.forename: Issei
authors.initials: I
authors.lastname: Komuro
authors.forename: Kenshi
authors.initials: K
authors.lastname: Fujii
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000601:surgery*; D016279:Atrial Function, Left / Q000502:physiology*; D017115:Catheter Ablation; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography