Left atrial (LA) function can help predict various cardiovascular events. Catheter ablation for atrial fibrillation (AF) modifies baseline LA function through the maintenance of sinus rhythm and myocardial injury. We investigated the impact of post-ablation LA function on recurrence of AF after ablation and identified the predictors of reduced post-ablation LA function. A total of 616 patients who underwent AF ablation (paroxysmal, N = 310; non-paroxysmal, N = 306) were retrospectively examined with cardiac computed tomography at baseline and 3 months after the final ablation procedure. Post-ablation LA emptying fraction (LAEF_post) was calculated. We evaluated the association between LAEF_post and recurrence of AF after the final ablation procedure. Further, we assessed the predictors of reduced LAEF_post. The recurrence rate of AF was 72.7% after the final ablation procedure [median follow-up 48 months (48.0, 48.0), total number of ablation sessions: 1.4 ± 0.7]. Multivariate analysis revealed that LAEF_post was associated with the recurrence of AF (hazard ratio/10% increase: 0.62, 95% confidence interval: 0.51–0.75, P < 0.0001). LAEF_post had a mild predictive power for recurrence of AF (c-statistics: 0.670, optimal cutoff: 26.36%, P < 0.0001). The recurrence-free proportion among patients with reduced LAEF_post (< 26.36%, N = 100) and those with preserved LAEF_post (≥ 26.36%, N = 516) was 40% and 79%, respectively (P < 0.0001). The predictors of reduced LAEF_post were low pre-ablation LAEF, high pre-ablation LA volume, low body mass index (BMI), and female sex. Further, reduced LAEF_post was associated with the total number of ablation sessions and extra-pulmonary vein LA ablation. In conclusion, reduced LAEF_post was associated with recurrence of AF after ablation. Advanced LA remodeling, low BMI, and female sex could predict reduced LAEF_post. Although additional ablation was associated with reduced LAEF_post, it remains unclear whether reduced LAEF_post resulted from the additional ablation. Reduced LAEF_post might help stratify patients with ablation-refractory AF.

左心房 (LA) 功能可以帮助预测各种心血管事件。心房颤动 (AF) 的导管消融通过维持窦性心律和心肌损伤来改变基线 LA 功能。我们研究了消融后 LA 功能对消融后 AF 复发的影响，并确定了消融后 LA 功能降低的预测因子。共有 616 名接受 AF 消融的患者（阵发性，N  = 310；非阵发性，N  = 306）在基线和最终消融手术后 3 个月进行心脏 CT 进行回顾性检查。计算消融后 LA 排空分数 (LAEF _post )。我们评估了 LAEF_{职位之间的关联}最终消融手术后 AF 复发。此外，我们评估了 LAEF _post减少的预测因子。最终消融术后 AF 复发率为 72.7% [中位随访 48 个月 (48.0, 48.0)，消融总次数：1.4 ± 0.7]。多变量分析显示，LAEF_后与 AF 的复发相关（风险比/10% 增加：0.62，95% 置信区间：0.51-0.75，P  < 0.0001）。LAEF _post对 AF 复发具有轻微的预测能力（c 统计量：0.670，最佳截止值：26.36%，P  < 0.0001）。_{LAEF 降低后}患者的无复发比例（< 26.36%，N = 100) 和保留 LAEF_柱的患者(≥ 26.36%, N  = 516) 分别为 40% 和 79% ( P  < 0.0001)。LAEF_术后减少的预测因素是消融前 LAEF 低、消融前 LA 体积高、体重指数 (BMI) 低和女性。此外，减少 LAEF_后与消融疗程和肺外静脉 LA 消融的总数有关。总之，减少 LAEF_后与消融后 AF 的复发有关。晚期 LA 重塑、低 BMI 和女性可以预测 LAEF_后减少。虽然额外的消融与 LAEF_后减少有关，但仍不清楚 LAEF 是否减少_职位是由额外的消融造成的。减少 LAEF_后可能有助于对消融难治性 AF 患者进行分层。