Atrial cardiomyopathy (ACM) is a pathological condition characterized by structural remodeling, electrophysiological abnormalities, and fibrosis of the atria. It is closely associated with atrial fibrillation (AF) recurrence following catheter ablation. Diffuse atrial fibrosis and electrical remodeling induced by ACM create a pro-arrhythmic substrate that not only perpetuates AF but also serves as a key structural determinant of post-ablation recurrence. Studies indicate that while ablation effectively isolates pulmonary veins, it fails to eliminate the underlying ACM substrate. Consequently, residual fibrotic regions persist, harboring non-pulmonary vein triggers and zones of slow conduction, which ultimately lead to recurrent AF or atrial tachycardia.This review systematically elucidates the pathological mechanisms linking ACM to post-ablation recurrence. By integrating multimodal non-invasive technologies—including echocardiography, cardiac magnetic resonance, body surface electroanatomical mapping, and circulating biomarkers—we establish a comprehensive assessment system encompassing structural, functional, and molecular dimensions. We evaluate the synergistic role of combining these multidimensional non-invasive parameters in risk prediction and propose an ACM-guided peri-procedural management strategy aimed at optimizing AF ablation outcomes.