Arrhythmias & electrophysiology

Baseline left atrial low-voltage area predicts recurrence after pulmonary vein isolation: WAVE-MAP atrial fibrillation (AF) results

EuropacePublished Prospective cohort study

Authors' conclusion

Larger extension of LVA was associated with an increased risk of arrhythmia recurrence.

Study context

Population
Patients with AF undergoing de novo pulmonary vein isolation (PVI)-only radiofrequency catheter ablation
Participants
300 patients · 18 centres
Exposure
Left atrial low-voltage area (LVA) extent vs AF/AF/atrial flutter (AFL)/atrial tachycardia (AT) recurrence after PVI-only ablation
  • Paroxysmal AF (PAF)n = 113
  • Early persistent AF (PsAF)n = 86
  • Non-early PsAFn = 101
Outcome
AF/AFL/AT recurrence after a single PVI procedure, by pre-ablation mapping characteristics
Follow-up
12 months
Methodological detailsmulticentre, 18 centres
  • Multicentre
  • 18 centres

Main finding

As reported in the abstract

AF/AFL/AT recurrence by LVA extent (Cox model)
Hazard ratio (95% CI)P value
Low-voltage area (<0.5 mV) >28% of the left atrium in SR
4.82(2.08–11.18)
P = 0.0003
>72% in AFLVA (<0.5 mV) >72% of the left atrium in AF
5.66(2.34–13.69)
P = 0.0001
Freedom from AF/AFL/AT recurrence at 12 months
75.5%

Observational data: associations, not effects.

Original publication

Baseline left atrial low-voltage area predicts recurrence after pulmonary vein isolation: WAVE-MAP AF results. Europace. Published 20 July 2023. doi:10.1093/europace/euad194

Summarised from the published abstract; every number is checked against it

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