Atrial reverse remodeling represented by the atrial conduction time in persistent atrial fibrillation patients after catheter ablation: its impact on predicting late atrial fibrillation recurrence

•Atrial conduction time to left atrial appendage (P-LAA TDI) was measured by transthoracic echocardiography.•P-LAA TDI exhibited a significant reduction by 6 months after persistent atrial fibrillation (AF) ablation.•Late AF recurrence was related to P-LAA TDI after the reverse remodeling of atrium. The aim of this study was to examine the reduction in the atrial conduction time during the follow-up phase of catheter ablation in persistent atrial fibrillation (PsAF) patients, which would suggest atrial reverse remodeling, and to investigate its impact on predicting AF recurrence. Fifty-seven PsAF patients underwent radiofrequency catheter ablation. The P-wave to left atrial appendage (LAA) conduction time was measured by transthoracic echocardiography using tissue Doppler imaging (P-LAA TDI), within 24 h and 6 months after ablation. The accuracy of the P-LAA TDI was confirmed by measuring the actual electrophysiological data during the ablation (90 ± 13 ms, r = 0.754, p