Long‐Term Outcome of Left Atrial Voltage‐Guided Substrate Ablation During Atrial Fibrillation: A Novel Adjunctive Ablation Strategy

• DOI: 10.1111/jce.13122
• Publication Date: 2016-11-16T16:04:59Z
• Authors: ATSUHIKO YAGISHITA; J. ROD GIMBEL; SAMER DE OLIVEIRA; HARISH MANYAM; DINA SPARANO; IVAN CAKULEV; JUDITH MACKALL; MAURICIO ARRUDA
• Keywords: Atrium (architecture)

Voltage‐Guided Atrial Fibrillation Substrate Ablation Introduction Left atrium (LA) low voltage area (LVA) on 3‐D electroanatomic bipolar mapping (EAVM), as a surrogate for scar, is associated with poor AF ablation outcome. We evaluated the long‐term outcome of an LVA‐guided atrial fibrillation (AF) substrate modification strategy adjunct to pulmonary vein isolation (PVI). Methods and Results Two hundred one consecutive patients (82% persistent/Non‐PAF, age 65 years), who underwent EAVM during prior PVI, were divided into 2 groups according presence or absence LVA outside PV antra, defined <0.5 mV. was performed after PVI in LVA. found 159 (79%). Non‐PAF (OR 3.851, P = 0.002) CHA DS ‐VAS c score 1.815, < 0.001) independent predictors After index procedure, 144 (72%) free from at 12 months. With multiple procedures, 148 (74%) median follow‐up 3.1 years recurrence. There no difference recurrence (log‐rank 0.746), complications (0% vs. 7%, 0.125) between groups. Neither nor predictor multivariate analysis. Conclusions Patients had equally favorable compared those without. As voltage‐guided may be important LA structural remodeling.