5. Discussion
In this observational study, we evaluated 405 patients who underwent initial AF ablation, and compared whole left atrial electrophysiological degeneration assessed by electroanatomical mapping parameters between patients with and without LVAs. We then explored clinical and mapping parameters predicting AF recurrence. The main findings were (1) patients with left atrial LVAs had a lower mean regional voltage throughout all 6 regions, and regional mean voltage reduction was more extensive than those without LVAs; (2) left atrial total conduction velocity was lower in patients with LVAs than in those without; and (3) mapping parameters representing whole left atrial electrophysiological degeneration such as left atrial total conduction velocity and the extension of mean regional voltage reduction independently predicted AF recurrence. To our knowledge, this is the first clinical study to explore the association between the presence of localized LVAs and whole left atrial electrophysiological degeneration.