Left Atrial Low Voltage Zone Is Associated With Some Risk Factors And Predicts Recurrence Risk In Patients With Non-valvular Atrial Fibrillation After Radiofrequency Ablation

ObjectiveTo analyze the relevant clinical risk factors associated with left atrial low voltage zone(LVZ)in patients with non-valvular atrial fibrillation(AF)undergoing radiofrequency catheter ablation(RFCA),and to investigate the predictive value for recurrence risk after RFCA.MethodsFrom January 1,2017 to December 31,2018,a total of 112 consecutive patients with non-valvular AF undergoing RFCA were recruited.LVZ in the left atrium was identified and quantified via three-dimension electroanatomical system bipolar voltage mapping under sinus rhythm during procedure.Based on the presence of LVZ,patients were divided into LVZ and Non-LVZ groups.Baseline clinical characteristics including gender,age,body mass index(BMI),smoking,drinking,type of AF,diabetes,hypertension,serum BNP level,hsCRP level were recorded.Patients were followed for AF recurrence after RFCA.ResultsOf 112 patients,76 patients had paroxysmal AF,36 patients had persistent AF,and LVZ was recorded in 34 patients.There were 28 AF recurrences over a median follow-up period of 13 months.The age,CHA2DS2-VASc score,HAS-BLED score and left atrial diameter(LAD)were all significantly higher in patients with LVZ than those without non-LVZ(P < 0.05).The proportion of combined with persistent AF,drinking history,coronary heart disease and previous cerebral infarction were also significantly higher compared to those with no LVZ(P < 0.05).Multivariate logistic regression analysis showed that age(HR:1.072,95%CI:1.001~1.148,P=0.047),persistent atrial fibrillation(HR:4.017,95%CI:1.333~12.104,P=0.013),drinking history(HR:5.391,95%CI:1.813~16.032,P=0.002)were positively correlated with LVZ.And on multivariate analysis to test the association between variables and the AF recurrence,age(HR:1.070,95%CI:1.014~1.129,P=0.014)and left atrial LVZ(HR:1.052,95%CI:1.004~1.103,P=0.034)were the independent predictors of AF recurrences.ConclusionSome risk factors such as age,persistent AF and drinking history are associated with the existence of LVZ.Left atrial LVZ may be the independent predictors of AF recurrence after RFCA,which may facilitatean optimal individualized treatment for patients with non-valvular AF.