Patients‘ population
This study included patients with non-valvular AF who underwent high-density voltage mapping after PV isolation at the Hyogo College of Medicine and Kawasaki Hospital between August 2019 and April 2020. From this initial population, patients who had a structural heart disease, or patients requiring LA ablation other than PV isolation were excluded from the study. The remaining 100 patients were included in our study analyses. AF was categorized into two types; paroxysmal AF (PAF) and non-PAF. All antiarrhythmic drugs were withheld at least 5 half-lives before CA procedure.
All patients underwent transthoracic echocardiography (TTE) within 1-month preceding the procedure. LA diameter, E wave, deceleration time, LV diameter during end diastole, the prevalence of LV hypertrophy, LV ejection fraction, and E/e‘ ratio were assessed. LA diameter was indexed for body size by dividing by body surface area (BSA) calculated using the Dubois formula. LA size assessed by LA diameter/BSA was categorized into normal / mildly (<2.6 cm/m2), moderately (2.7-2.9 cm/m2), or severely (≥3.0 cm/m2) enlarged LA according to current recommendations.8 All patients were older than 18 years of age and provided written informed consent to the procedures. The study protocol complied with the Declaration of Helsinki and was approved by the appointed local ethics committee (The Ethics Review Board of Hyogo College of Medicine, Reference number: 3477).