2. Introduction
Catheter ablation has become a mainstream treatment option for atrial fibrillation (AF). Electrical pulmonary vein isolation (PVI) is well established as the cornerstone of AF ablation.1,2However, frequent AF recurrence after ablation remains an unsolved problem, with reported 1-year AF recurrence rates of 20-50%.2-4
The presence of left atrial low-voltage areas (LVAs) has been reported to be strongly associated with AF recurrence after ablation.5-7 Nevertheless, several randomized control trials evaluating the efficacy of LVA ablation in addition to PVI reported controversial results8-11 which suggested that extra-pulmonary-vein AF substrate does not always localized within LVAs.
The purpose of this study was to compare whole left atrial electrophysiological degeneration between patients with and without localize LVAs, and to explore clinical and mapping data associated with AF recurrence after ablation.