Key result
Impaired left atrial reservoir strain emerges as the strongest echocardiographic predictor of post-ablation AF recurrence.
Why the study?
Echocardiographic markers of atrial remodeling are associated with AF recurrence after catheter ablation, but the relative strength and consistency of these associations across atrial functional, structural, diastolic, and ventricular domains remained unclear.
Do echocardiographic markers of atrial remodeling (such as left atrial reservoir strain) better predict atrial fibrillation recurrence after catheter ablation compared to conventional structural, diastolic, and ventricular systolic parameters?
Meta-Analysis
Do echocardiographic markers of atrial remodeling (such as left atrial reservoir strain) better predict atrial fibrillation recurrence after catheter ablation compared to conventional structural, diastolic, and ventricular systolic parameters?
Left atrial reservoir strain provides a stronger and more consistent prediction of atrial fibrillation recurrence after catheter ablation than conventional structural, diastolic, or ventricular systolic echocardiographic parameters.
Answers are grounded in this paper and cite their sources.
LA reservoir strain may enhance post-ablation AF recurrence prediction; extends evidence by outperforming conventional echocardiographic parameters with high consistency.
Background: Echocardiographic markers reflecting atrial remodeling have been associated with atrial fibrillation (AF) recurrence after catheter ablation. However, the relative strength and consistency of these associations across atrial functional, structural, diastolic, and ventricular domains remain unclear. Methods: We performed a systematic review and meta-analysis of studies evaluating echocardiographic predictors of AF recurrence after catheter ablation. Standardized mean differences (Hedges' g) were pooled using random-effects models. Echocardiographic parameters were categorized into atrial functional, atrial structural, diastolic, and ventricular systolic domains. Results: Twenty-eight studies were analyzed, mean age of perticipants was 59.3 years and 70.8% patients were male. Left atrial (LA) reservoir strain demonstrated the strongest and most consistent association with AF recurrence (g = –0.67, 95% CI –0.83 to –0.51; I 2 = 0%). Among structural markers, left atrial volume index (LAVI) (g = 0.48, 95% CI 0.28-0.69; I 2 = 88%) and LA diameter (g = 0.44, 95% CI 0.30-0.58; I 2 = 68%) showed moderate associations with recurrence. E/e′ demonstrated a modest association (g = 0.37, 95% CI 0.21-0.53; I 2 = 79%), whereas left ventricular ejection fraction showed only a minimal association (g = –0.11, 95% CI –0.18 to –0.03; I 2 = 34%). Conclusions: Markers of atrial remodelling, particularly LA reservoir strain, demonstrated stronger and more consistent associations with AF recurrence after catheter ablation than conventional structural, diastolic, or ventricular systolic parameters. These findings support the incremental value of advanced atrial functional assessment for recurrence risk stratification
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Sharma et al. (2026) conducted a meta-analysis in Atrial fibrillation undergoing catheter ablation. Left atrial reservoir strain and echocardiographic markers of atrial remodeling vs. Conventional structural (LAVI, LA diameter), diastolic (E/e'), and ventricular systolic (LVEF) parameters was evaluated on Atrial fibrillation recurrence after catheter ablation (SMD -0.67, 95% CI -0.83 to -0.51). Left atrial reservoir strain showed the strongest association with AF recurrence after ablation (Hedges' g = -0.67; 95% CI -0.83 to -0.51; I² = 0%).
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