Left Atrial and Left Ventricular Structural and Functional Evaluation by CCTA for Predicting Post-Ablation Outcomes in Patients With Atrial Fibrillation

Using CCTA to Assess Heart Function and Predict AF Recurrence After Ablation

This study aims to evaluate whether structural and functional parameters of the left atrium and left ventricle, measured by cardiac computed tomography angiography (CCTA), can predict clinical outcomes after radiofrequency ablation in patients with atrial fibrillation (AF). Atrial fibrillation is a common heart rhythm disorder, and while catheter ablation is an effective treatment, some patients experience recurrence. Current predictive tools have limitations. This prospective observational study will enroll patients with AF scheduled for first-time radiofrequency ablation. All participants will undergo CCTA before the ablation procedure to assess left atrial and left ventricular volumes, ejection fraction, and strain parameters. After ablation, patients will be followed for 12 months to monitor recurrence of atrial arrhythmias. The primary outcome is the recurrence of atrial fibrillation or atrial tachycardia lasting more than 30 seconds after a 3-month blanking period. The study will determine whether CCTA-derived parameters improve risk stratification for post-ablation recurrence. Findings may help identify patients who are more likely to benefit from ablation or who may need additional therapy.

Inclusion Criteria:

1. Meet the indications for radiofrequency ablation recommended by relevant atrial fibrillation diagnosis and treatment guidelines
2. Age ≥ 18 years
3. First-time radiofrequency ablation

Exclusion Criteria:

1. history of cardiac ablation
2. structural heart diseases, such as cardiomyopathy, valvular disease, heart failure, and acute myocardial infarction
3. severe renal failure (estimated glomerular filtration rate <30 ml/m2)
4. left ventricular (LV) ejection fraction <30%
5. poor image quality inadequate for assessment