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.