The presence of pre-ablation left atrial low voltage areas predicted an increased risk of recurrent atrial fibrillation after catheter ablation (HR 2.87; 95% CI 2.33-3.52).
Meta-Analysis (n=1,070)
Does the presence of pre-ablation left atrial low voltage areas predict recurrence of atrial fibrillation after catheter ablation?
Pre-ablation left atrial low voltage areas are a strong predictor of atrial fibrillation recurrence following catheter ablation, highlighting the prognostic value of voltage mapping.
Hazard Ratio: 2.87 (95% CI 2.33–3.52)
BACKGROUND: Low voltage areas (LVAs) on left atrial (LA) voltage mapping correlate with atrial fibrosis. However, there is no uniform standard for the definition of LVAs, or mapping techniques and mapping rhythms, so that the predictive value of left atrial LVAs for recurrence of atrial fibrillation (AF) is uncertain. This study aimed to explore the relationship between the presence of pre-ablation left atrial LVAs and the risk of recurrent AF after catheter ablation. METHODS: The databases of PubMed, Embase, Web of science, Cochrane library, Scopus, Wanfang Datebase, China National Knowledge Infrastructure, China Biology Medicine and China Scientific Journal Datebase were searched from inception to 31 July 2023. Relevant studies regarding left atrial LVAs prior to ablation to predict postoperative recurrence of AF were identified and analyzed. The efficacy endpoints were defined as the recurrence of atrial arrhythmia lasting over 30 s. RESULTS: A total of 12 studies with 1070 patients were included. We found the presence of pre-ablation left atrial LVAs correlated with the risk of recurrent AF after ablation (hazard ratio (HR) = 2.87, 95% confidence interval (CI): 2.33-3.52). The presence of pre-ablation left atrial LVAs can predict the risk of recurrent AF after ablation both in the follow-up duration ≤12 months group and follow-up duration >12 months group (follow-up duration ≤12 months: HR = 2.93, 95% CI: 2.20-3.90; follow-up duration >12 months: HR = 2.80, 95% CI: 2.09-3.77). The presence of pre-ablation left atrial LVAs correlated with the risk of recurrent AF after ablation in paroxysmal AF (HR = 2.89, 95% CI: 1.97-4.24). CONCLUSIONS: The presence of pre-ablation left atrial LVAs correlate with the risk of recurrent AF after catheter ablation.
Zhang et al. (Sun,) conducted a meta-analysis in Atrial Fibrillation (n=1,070). Pre-ablation left atrial low voltage areas (LVAs) vs. Absence of pre-ablation left atrial LVAs was evaluated on Recurrence of atrial arrhythmia lasting over 30 s (HR 2.87, 95% CI 2.33-3.52). The presence of pre-ablation left atrial low voltage areas predicted an increased risk of recurrent atrial fibrillation after catheter ablation (HR 2.87; 95% CI 2.33-3.52).