{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T19:05:40Z","timestamp":1761419140220,"version":"3.37.3"},"reference-count":35,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,8,16]],"date-time":"2017-08-16T00:00:00Z","timestamp":1502841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Atrial low\u2010voltage zones (LVZ) are suggested as important factors for maintaining persistent atrial fibrillation (PsAF). The relationship between LVZs and left atrial (LA) contact areas (CoAs) is still unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess whether CoA regions were involved in atrial substrate properties maintaining PsAF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 50 patients with PsAF (36 long\u2010lasting) were analyzed. Three representative CoA detection areas (ascending aorta\u2010anterior\u2010LA, descending aorta\u2010left pulmonary vein antrum, and vertebrae\u2010posterior\u2010LA) were registered on the mapping geometry. Electrograms during AF and sinus rhythm (SR) were acquired, and the fractionated electrograms (CFE;\u00a0&lt;\u00a080milliseconds) and voltages were analyzed regarding the CoAs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After SR conversion, 76% (38\/50) had a significant LVZ (&gt;5% of the total LA surface area). Patients with long\u2010lasting PsAF versus PsAF had larger CoA areas (7.7 \u00b1 3.0\u00a0vs. 4.5 \u00b1 2.5cm<jats:sup>2<\/jats:sup>, P\u00a0&lt;\u00a00.05) and overlapped\u2010LVZs (8.2 [3.2\u201311.0] vs. 2.1 [0.7\u20133.7] cm<jats:sup>2<\/jats:sup>, P\u00a0=\u00a00.0126) between the SR\u2010LVZs (&lt;0.5\u00a0mV) and AF\u2010LVZs (&lt;0.2\u00a0mV). Overlapped\u2010LVZs were frequently observed in CoA regions (anterior 76.4%; LIPV antrum 78.8%, and vertebrae 39.2%), and those LVZs had smaller unipolar voltages than those distant from the CoA regions (0.64 \u00b1 0.16\u00a0vs. 2.5 \u00b1 1.5\u00a0mV, P\u00a0&lt;\u00a00.0001). SR\u2010LVZ targeted ablation, including of CoA regions, rendered AF termination (n\u00a0=\u00a08, 21%), and 88% of the sites were not located immediately above, but adjacent to, the overlapped\u2010LVZs. Significant AF slowing (6.0 \u00b1 0.6 to 5.6 \u00b1 0.6\u00a0Hz; P\u00a0&lt;\u00a00.05) accompanied by unintentional CFE elimination (9.8\u20131.8 cm<jats:sup>2<\/jats:sup>; P\u00a0&lt;\u00a0.0001) was achieved in patients without termination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data suggested that external structures in contact with the LA are involved in the creation of localized diseased myocardium necessary for PsAF maintenance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.13301","type":"journal-article","created":{"date-parts":[[2017,7,20]],"date-time":"2017-07-20T09:50:21Z","timestamp":1500544221000},"page":"1259-1268","source":"Crossref","is-referenced-by-count":6,"title":["Influence of the left atrial contact areas on fixed low\u2010voltage zones during atrial fibrillation and sinus rhythm in persistent atrial fibrillation"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6388-4398","authenticated-orcid":false,"given":"Shiro","family":"Nakahara","sequence":"first","affiliation":[{"name":"Department of Cardiology Dokkyo Medical University Koshigaya Hospital  Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichi","family":"Hori","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dokkyo Medical University Koshigaya Hospital  Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Nishiyama","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dokkyo Medical University Koshigaya Hospital  Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuo","family":"Okumura","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Nihon University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reiko","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dokkyo Medical University Koshigaya Hospital  Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sayuki","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dokkyo Medical University Koshigaya Hospital  Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takaaki","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dokkyo Medical University Koshigaya Hospital  Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiko","family":"Sakai","sequence":"additional","affiliation":[{"name":"Department of Cardiology Dokkyo Medical University Koshigaya Hospital  Saitama 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