Impact of unipolar voltage criteria for left atrial posterior wall on atrial fibrillation recurrence after pulmonary vein isolation

• Published in: Journal of cardiovascular electrophysiology 2023-04, Vol.34 (4), p.849-859
• Main Authors: Watanabe, Tomonori, Watanabe, Hiroaki, Hachiya, Hitoshi, Sato, Masafumi, Mitama, Tadayuki, Okuyama, Takafumi, Yokota, Ayako, Kamioka, Masashi, Komori, Takahiro, Kabutoya, Tomoyuki, Imai, Yasushi, Kario, Kazuomi
• Format: Article
• Language: English
• Subjects: Arrhythmia; atrial arrhythmia; Atrial Fibrillation - surgery; atrial remodeling; Body mass index; Cardiac arrhythmia; catheter ablation; Catheter Ablation - methods; Etiology; Fibrillation; Heart Atria; Humans; low‐voltage area; Middle Aged; Pulmonary Veins - surgery; Radiofrequency ablation; Retrospective Studies; Treatment Outcome; Voltage; voltage mapping
• ISSN: 1045-3873; 1540-8167
• DOI: 10.1111/jce.15838

Introduction Beyond pulmonary vein isolation (PVI), additional therapeutic strategies for atrial fibrillation (AF) have not been established. Remodeling of the left atrium (LA) could impact AF recurrence post‐PVI. We investigated the impact of unipolar voltage (UV) criteria for the LA posterior wall (LA‐PW) on AF recurrence post‐PVI. Methods We reviewed the cases of 106 AF patients (mean age 63.8 years, nonparoxysmal AF: 59%) who underwent extensive encircling PVI by radiofrequency ablation guided by a 3‐dimension mapping system, investigating the impact on AF recurrence of the UV criteria of the LA. Results Out of all patients, 26 patients had AF recurrence during post‐PVI follow‐up [median 603 days]. They showed a higher percentage of nonparoxysmal AF (80.8 vs. 52.5%, p = .011), longer AF duration (2.9 ± 2.7 vs. 1.0 ± 1.7 years, p = .002), and larger area size of UV