Clinical implication
To the best of our knowledge, this
is the first study to identify a relationship between the ACZ and the
LVA/LA anatomical CoAs in patients with AF.
To improve the outcome after CA
for AF, a more detailed understanding of the LA activation is essential.
Consequently, the assessment of the ACZ might have
a critical implication in risk
stratification of atrial tachyarrhythmias recurrence after the CA, and
could be helpful in providing an appropriate new strategy for CA. A
prior study suggested that the LA posterior wall plays an important role
in both initiation and the maintenance of AF, and a recent systematic
review showed the efficacy of posterior wall isolation for
AF.19 These findings indirectly suggest that the
posterior ACZ may play an important role in patients with AF. However,
we did not investigate the association between the ACZ and the
recurrence of AF. Further study will be necessary to determine which
position of the ACZ is important in AF.