The Prevalence of Low Voltage in Left Atrium in Persistent Atrial Fibrillation: Examination in Cases Maintaining Sinus Rhythm after Pharmacologic Defibrillation

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Introduction: The ablation strategy for persistent atrial fibrillation (PerAF) has not been established yet. The outcome of pulmonary vein isolation (PVI) in the cases with maintaining sinus rhythm (SR) with antiarrhythmic agents (AAD) after defibrillation (Respond PerAF; R-Per) has reported similar with the paroxysmal cases (PAF). We examined the prevalence of low voltage area of left atrial (LA) in R-Per cases. Method: Nine R-Per cases receiving a first PVI were examined (age 63.8±9; males, 8). PVI was conducted using Carto with circular mapping catheters. No LA additional ablation (ABL) was added. Thelow voltage areas (LVA) of LA measured by Cartro were recorded during SR before PVI. LVA was indicated as %LVA0.5 and %LVA1.0 (below 0.5 mV and below 1.0 mV). These were compared with that of 5 PAF cases (age 62.1±9.6; males, 5). LVA of septum area was not included because of insufficient recording. Results: The %LVA0.5 and %LVA1.0 were 19.9±18.2% and 54.4±32.1% in R-Per cases and 3.5±5.6% and 5.2±2.9% in PAF cases, respectively. In both cases, an LVA was commonly observed near the PVs. Conclusions: LVAs were more common in R-Per than PAF cases, and were prevalent around the PVs.
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