Dilated LA significantly increases the risk of AF recurrence after  single CPVI .
This is especially applicable to the patients with long-term follow-up
AIMS Left atrial ( LA ) enlargement is associated with atrial fibrillation ( AF ) .
However , it is controversial whether dilated atrium can predict post-ablation AF recurrence .
We undertook a systematic review and meta- analysis to analyse the association between LA diameter and  AF recurrence after single circumferential pulmonary vein isolation ( CPVI )  and explore the potential mechanism .
Are transthoracic echocardiographic parameters associated with atrial fibrillation recurrence or stroke? Results from the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) study.
OBJECTIVES The purpose of this study was to evaluate the associations of transthoracic echocardiographic parameters with recurrent atrial fibrillation ( AF ) and /or stroke . BACKGROUND The Atrial Fibrillation Follow-up Investigation of Rhythm Management ( AFFIRM ) study , an evaluation of elderly patients with AF at risk for stroke , provided an opportunity to evaluate the implication s of echocardiographic parameters in patients with AF . METHODS  Transthoracic echocardiographic measures of mitral regurgitation ( MR ) , left atrial ( LA ) diameter , and left ventricular ( LV ) function were evaluated in the AFFIRM rate- and rhythm-control patients who had sinus rhythm resume and had these data available .  Risk for recurrent AF or stroke was evaluated with respect to transthoracic echocardiographic measures . RESULTS Of 2,474 patients studied , 457 had > or = 2(+)/4(+ ) MR , and 726 had a LA diameter > 4.5 cm . The  LV ejection fraction was abnormal in 543 patients . The cumulative probabilities of at least one AF recurrence/stroke were 46%/1 % after 1 year and 84%/5 % by the end of the trial ( > 5 years ) , respectively . Multivariate analysis showed that r and omization to the rhythm-control arm ( hazard ratio [ HR ] = 0.64 ; p < 0.0001 ) and a qualifying episode of AF being the first known episode ( HR = 0.70 ; p < 0.0001 ) were associated with decreased risk . Duration of qualifying AF episode > 48 h ( HR = 1.55 ; p < 0.0001 ) and LA diameter ( p = 0.008 ) were associated with an increased risk of recurrent AF . Recurrent AF was more likely with larger LA diameters ( HR = 1.21 , 1.16 , and 1.32 for mild , moderate , and severe enlargement , respectively ) . No transthoracic echocardiographic measures were associated with risk of stroke . CONCLUSIONS In the AFFIRM study , large transthoracic echocardiographic LA diameters were associated with recurrent AF , but no measured echocardiographic parameter was associated with stroke
Dilated LA significantly increases the risk of AF recurrence after  single CPVI .
This is especially applicable to the patients with long-term follow-up
AIMS Left atrial ( LA ) enlargement is associated with atrial fibrillation ( AF ) .
However , it is controversial whether dilated atrium can predict post-ablation AF recurrence .
We undertook a systematic review and meta- analysis to analyse the association between LA diameter and  AF recurrence after single circumferential pulmonary vein isolation ( CPVI )  and explore the potential mechanism .