Assessment of left atrial mechanical and hemodynamic function in preparation for ablation of atrial fibrillation – A systematic review

<ns3:p>Atrial fibrillation (AF) is the most common sustained arrhythmia in the general population, with its prevalence estimated at 2–25% depending on the age group. The treatment and prevention of AF is a complex issue, and pulmonary vein isolation ablation (PVI) is becoming increasingly used among invasive AF management methods. The diagnostic process and prediction of PVI outcomes remain among the greatest challenges in the interventional treatment of AF.Among the methods that may allow assessment of mechanical and haemodynamic atrial function or prediction of arrhythmia recurrence after PVI, the commonly used ones were selected: electrocardiography, echocardiography, cardiac computed tomography (CT), cardiac magnetic resonance imaging (CMR), and selected laboratory tests. A systematic review of selected scientific publications from 1960 to 2025 available in the PubMed database was conducted. The most important original papers and meta-analyses were included. This review discusses the usefulness of selected diagnostic methods in the direct and indirect prediction of arrhythmia recurrence after PVI.The use of advanced imaging tests allows for a detailed description of the structure and function of the left atrium, and also supports the planning and safety of ablation procedures. Less complex and widely available tools, such as electrocardiography or selected laboratory tests, might be helpful in the initial prediction of the procedure’s effectiveness, especially during very early screening. All diagnostic procedures analyzed in this systematic review – regardless of their complexity – are of high importance in decision-making on the optimal therapeutic strategy.</ns3:p>