Impact of left atrial appendage occlusion on early left atrial remodeling in atrial fibrillation patients:a CCTA-based study
LI Ziduan
LI Jun
WANG Qingsong
SONG Tingting
GUO Jun
CHEN Tao
Abstract：Objective Left atrial appendage occlusion(LAAO)has emerged as an effective alternative for atrial fibrillation(AF)patients with contraindications to anticoagulation therapy.The impact of LAAO on the structure and function of the left atrium(LA)remains controversial.Based on cardiac computed tomography angiography(CCTA),this study quantitatively analyzed the effects of LAAO on left atrial volume and left atrial ejection fraction(LAEF)in patients with AF.Methods A single-center retrospective cohort of 185 non-valvular AF patients(67 paroxysmal,118 persistent)undergoing LAAO without concomitant ablation from January 2021 to December 2024 was analyzed.LA maximal volume(LAVmax),minimal volume(LAVmin),and LA ejection fraction(LAEF)were measured by CCTA at baseline and 3-month follow-up.Paired Wilcoxon tests compared pre-and post-procedural changes.Results The baseline LAVmax in the persistent atrial fibrillation group was higher than that in the paroxysmal atrial fibrillation group[166.91(140.475,196.07)vs.141.72(118.865,169.635);Z=0.668,P<0.001].The baseline LAVmin was also higher in the persistent atrial fibrillation group than in the paroxysmal atrial fibrillation group[145.6(123.185,174.99)vs.125.35(101.35,153.6);Z=0.629,P<0.001].At the 3month followup after operation,LAVmax[161.12(136.032,189.183)]and LAVmin[143.12(120.005,174.098)]in the persistent atrial fibrillation group were significantly decreased compared with preoperative baseline,respectively[LAVmax:166.91(140.475,196.07),Z=9.189,P<0.001;LAVmin:145.6(123.185,174.99),Z=8.472,P=0.008].Conclusion LAAO induces early LA reverse remodeling(volume reduction)in persistent AF but not in paroxysmal AF,without improving systolic function.This"structure-function dissociation"supports personalized AF management strategies.
Keywords：left atrial appendage occlusionnon-valvular atrial fibrillationcardiac computed tomography angiographyleft atrial remodeling
Publication Date：2026-02-28
Online Publishing Date：2026-03-19(First online date of this platform, not the publication date of the document)
Pages：5( 120-124 )