Maier J, Blessberger H, Nahler M, et al. - Catheter ablation is frequently performed for treating patients with symptomatic, drug-refractory atrial fibrillation (AF). In view of the established value of cryo-ablation as an alternative to radiofrequency ablation, researchers here conducted a single centre retrospective data analysis with the aim to determine the impact of the left atrial volume index (LAVI), derived from cardiac computed tomography (cCT) data, on the long-term outcome of ablation-naïve AF patients, after their first cryo-ablation. Included were 415 patients (n = 290 [69.90%] male, 60.00[IQR:53.00-68.00] years old) undergoing a cCT and subsequent cryo-ablation index procedure. Long-term follow-up data yielded no evidence of AF recurrence in 224 patients suggesting a success rate of 53.98% in this cryo-ablation-naïve cohort. Patients’ left atrial volume index (LAVI), as well as AF type and BMI, were identified influencing the success. In addition to extending the previous investigations, the results indicate the predictive value of CT-derived LAVI. The predictive power of CT-derived LAVI may be underestimated by the current AF recurrence risk scores.