Objective. To evaluate the impact of left atrial anatomical features and pulmonary vein variants on the effectiveness of interventional treatment in patients with paroxysmal atrial fibrillation (AF). Material and methods. A single-center prospective study included 248 patients with paroxysmal AF who underwent catheter ablation in 2023–2024. Advanced imaging techniques were used, including multislice computed tomography, transesophageal and transthoracic echocardiography, and electroanatomical mapping. Morphological parameters of the left atrium (LA) and pulmonary veins (PVs) were assessed: number of PV ostia, their diameter, shape, presence of a common trunk or accessory veins. Patients underwent either radiofrequency or cryoballoon ablation. Outcomes were evaluated based on recurrence of AF at 3, 6, 12 months post-procedure. Results. Typical left atrial and pulmonary vein anatomy was observed in 56.1% of patients, while atypical anatomy was found in 43.9%. Among the latter, the most common variants included accessory pulmonary veins (13.3%), a common pulmonary vein trunk (10.1%), and combined anatomical variants (20.5%). The overall 12-month recurrence rate of AF was 14.1%, with a significantly higher rate among patients with atypical PV anatomy (p = 0.0049). The highest recurrence rates were observed in patients with accessory veins (28.6%, p = 0.0045) and combined anatomical variants (20%, p = 0.0346). In patients with typical anatomy, recurrence occurred in only 8.5% of cases. Additionally, an association was found between enlarged left atrial size, reduced ejection fraction, and recurrence risk. Conclusion. The anatomical features of the left atrium and pulmonary veins are significant predictors of the outcome of interventional treatment for AF. Preoperative morphological assessment using computed tomography ces the risk of recurrence. Further studies are needed to develop predictive models that incorporate anatomical parameters.