Discussion
In this study, we found that the extent of LVAs was an independent predictor for recurrence even after multiple procedures. The efficacy of catheter ablation was limited in patients with extensive LVAs. In patients with extensive LVAs, the indications and strategies for additional treatment should be carefully considered. In addition, female, lower BMI, and larger LAD were shown to be predictors of extensive LVAs. These findings suggest that the results of voltage mapping after initial PVI can predict the clinical course of second and subsequent treatments.