Arrhythmias & electrophysiologyMeta-analysis
Prevalence and multiple predictors of left atrial low voltage in paroxysmal and non-paroxysmal atrial fibrillation patients undergoing ablation: a systematic review and meta-analysis
- Systematic review and meta-analysis
- meta-regression
Authors' conclusion
Low-voltage areas can be present in both paroxysmal and non-paroxysmal AF, and can be predicted by multiple clinical, echocardiographic, and biomarker variables. The impact of female sex, LA diameter, and BMI on LVA presence varies according to the type of AF.
Study context
- Population
- Atrial fibrillation (AF) patients undergoing left atrium (LA) catheter ablation with electroanatomic mapping
- Participants
- 5,278 patients · 22 studies
- Comparison
- AF patients with vs without LA low-voltage areas
- Outcome
- Prevalence and predictors of LA low-voltage areas (LVAs)
Pooled result
As reported in the abstract
Prevalence of LVAs
- Predictor of LVA: age > 65 years, OR
- 3.41
- Predictor of LVA: CHA2DS2-VASc score, OR
- 3.29
- Predictor of LVA: non-paroxysmal AF, OR
- 3.19
- Predictor of LVA: NT-proBNP > 365 pg/mL, OR
- 2.47
- Predictor of LVA: female sex, OR
- 2.40
- Predictor of LVA: E/e' ratio, OR
- 2.31
- Predictor of LVA: eGFR < 60 mL/min/m², OR
- 2.28
- Predictor of LVA: LA volume indexed > 34 mL/m², OR
- 1.98
Further pooled results
Predictors of LVA by AF type (subgroup)
- Female sex, predictor only in non-paroxysmal AF, OR
- 3.90
- LA diameter, predictor only in paroxysmal AF, OR
- 2.51
- Body mass index (BMI), predictor only in paroxysmal AF, OR
- 1.85
Meta-regression
- Non-paroxysmal AF and age independently and significantly associated with greater reduction in BMI in patients with vs without low-voltage areas (LVAs)
Original publication
Prevalence and multiple predictors of left atrial low voltage in paroxysmal and non-paroxysmal atrial fibrillation patients undergoing ablation: a systematic review and meta-analysis. Europace. Published 2 September 2025. doi:10.1093/europace/euaf206
Summarised from the published abstract; every number is checked against it