Assessment of left atrial shape and volume in structural remodeling secondary to atrial fibrillation

Assessment of volume in relation with left atrial (LA) shape alteration before and after PV isolation. We compared trapezoidal modification of LA using echocardiography with the ellipsoid formula (Eel) and CT, with both ellipsoid (CTel) and truncated cone formulas (CTtr), in 40 patients, before and +/- 3 months after AF ablation. A trapezoidal shape was present in 76.3% of patients. The different volume measurements were statistically correlated (r = 0.603-0.837, p < 0.001) irrespective of the formula used. After reverse remodeling, with 77.5% of patients in stable sinus rhythm, correlation coefficient for volume remained significant (p < 0.001). In AF, dilation of the LA is associated with a geometrical trapezoidal change in many cases. The CT truncated cone formula applies best for precise evaluation of trapezoidal shape alteration in dilated AF atria. There is a good correlation between CTtr and echocardiography which remains a valuable estimation for volume calculation in clinical practice.