It Is Necessary to Re-understand the Low-Voltage Area in Atrial Fibrillation Patients

The presence of a low-voltage areas (LVAs) is a major feature of the progression of atrial fibrillation. Typically, the LVA is determined by invasive left atrial voltage mapping. In addition to pulmonary vein electrical isolation, Voltage-guided substrate modification by targeting LVAs in addition to PVI has been shown to be superior to conventional PVI “only” approaches regarding freedom from AF recurrences after ablation. Recent studies have found Atrial wall thickness correlates with low voltage areas, and the degree of atrial myocardial fibrosis can be better assessed by CT or MRI in combination with voltage mapping, which might help reduce the recurrence of AF after catheter ablation.