Arrhythmias & electrophysiologySecondary analysis
Increased Heart Failure Risk After Low-Voltage-Area Ablation in Patients With Paroxysmal Atrial Fibrillation
- long-term follow-up analysis of the Volatile Coronary Lesion and Obstructive Nodal Atrial Fibrillation trial
Authors' conclusion
Among patients with paroxysmal AF and LVAs, LVA ablation was associated with a higher incidence of HF hospitalization despite a high rate of sinus rhythm maintenance. Given the limited sample size and number of events, these findings should be considered exploratory and hypothesis-generating, and warrant confirmation in larger prospective studies.
Study context
- Population
- Patients undergoing catheter ablation for paroxysmal atrial fibrillation (AF)patients followed for up to 7 years
- Participants
- 398 patients
- Comparison
- association between low-voltage area (LVA) ablation and heart failure (HF) outcomes after catheter ablation for paroxysmal atrial fibrillation (AF)
- Primary endpoint
- HF hospitalization
- Follow-up
- Median 1,660 (735-2,555) days
Primary result
As reported in the abstract
- patients with LVAs vs patients without LVAs · higher with LVAs
- incidence 18% vs 3%; P < 0.001
- LVA ablation vs no LVA ablation · among patients with LVAs; higher with LVA ablation
- incidence 30% vs 6%; P = 0.01
- HF hospitalization occurred in patients
- 21
Further findings
Sinus rhythm maintenance
- Sinus rhythm maintained
- 96%
- no differences among groups
- P = 0.26
Original publication
Increased Heart Failure Risk After Low-Voltage-Area Ablation in Patients With Paroxysmal Atrial Fibrillation. JACC Clin Electrophysiol. Published 24 September 2026. doi:10.1016/j.jacep.2026.08.022
Summarised from the published abstract; every number is checked against it