Background: Left atrial (LA) low-voltage area (LVA) has been reported to be associated with poor outcome of AF ablation. Although a regional distribution of LVA is various, AF ablation outcome in terms of regional distribution of LVA is not clear.
Objective: To assess AF ablation outcome in terms of LVA regional distribution.
Methods: This study included 197 consecutive AF patients (45% persistent, age 67.0 ± 9.5 years). Voltage mapping was performed during sinus rhythm after pulmonary vein isolation, and LVA was defined as bipolar voltage of <0.5 mV. Patients were divided into 3 groups according to LVA distribution (group 1, no LVA; group 2, LVA existed at the regions except for roof or posterior of LA; group 3, LVA in roof and/or posterior of LA). AF recurrence rates in the three groups were assessed.
Results: LVA was found in 82 (42%) patients (33 patients in group 2, 49 patients in group 3). During a median follow-up period of 16.8 months, AF recurrence occurred in 34 (17%) patients. AF recurrence was more frequently observed in the group 3 than in group 1 and 2. Presence of roof or posterior LVA was an independent predictor of AF recurrence in a multivariate analysis incorporating age, gender, body mass index, and left atrial diameter(Hazard ration, 2.52; 95% confidence interval,1.18-5.37; P = 0.0167).
Conclusion: The adverse prognostic impact of LVA was prominent when it existed at posterior and/or roof regions rather than at the other regions.