{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:50:06Z","timestamp":1791949806550,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Low\u2010voltage areas (LVA) in the left atrium (LA) have been linked to atrial fibrillation (AF) recurrence. However, prior studies lacked high\u2010density mapping catheter (HMDC) mapping, included non\u2010pulmonary vein isolation (PVI) ablation strategies, and did not follow temporal progression of LVA in individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 1661 AF patients who had undergone initial ablation using PVI alone, and in whom voltage maps of the LA had been created with HDMCs. We investigated the relationship between LVA size (Small\u2010LVA group: LVA\u2009&lt;\u20095\u2009cm\n                      <jats:sup>2<\/jats:sup>\n                      and Extensive\u2010LVA group: LVA\u2009\u2265\u20095\u2009cm\n                      <jats:sup>2<\/jats:sup>\n                      ) and AF recurrence. HDMCs were again used to map the LA at the time of the re\u2010do ablation. A total of 711 patients met our inclusion criteria (Small\u2010LVA 554, Extensive\u2010LVA 157). During the mean follow\u2010up period of 643.6\u2009\u00b1\u2009490.5 days, 21% of Small\u2010LVA patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009117) and 33% of Extensive\u2010LVA patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200952) experienced recurrence (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.005), of whom 106 (63%) underwent redo ablation. Belonging to the Extensive\u2010LVA group was predictive of AF recurrence both after the initial ablation and after the redo ablation. They also exhibited greater non\u2013PV related recurrence. Time\u2010dependent progression of LVA was observed in 32 patients with a mean increase of 4.7\u2009\u00b1\u20095.1\u2009cm\n                      <jats:sup>2<\/jats:sup>\n                      and was significantly more frequent in the Extensive\u2010LVA group. This progression was not linked to AF recurrence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We used high\u2010density mapping to evaluate left atrial LVA in patients who had only received PVI, and demonstrated LVA influence on AF recurrence and recurrence patterns.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70463","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T18:05:51Z","timestamp":1787249151000},"page":"2270-2279","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Low Voltage Areas in the Left Atrium After Sole Pulmonary Vein Isolation as a Predictor of Atrial Fibrillation Recurrence\u2014Based on Sequential Voltage Map Analysis Using High\u2010Density Mapping Catheters"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3388-2508","authenticated-orcid":false,"given":"Satoshi","family":"Hara","sequence":"first","affiliation":[{"name":"Cardiovascular Center Tsuchiura Kyodo Hospital, Tsuchiura Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3781-2171","authenticated-orcid":false,"given":"Shigeki","family":"Kusa","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Tsuchiura Kyodo Hospital, Tsuchiura Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoyuki","family":"Miwa","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Tsuchiura Kyodo Hospital, Tsuchiura Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3939-4954","authenticated-orcid":false,"given":"Yoshikazu","family":"Sato","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Tsuchiura Kyodo Hospital, Tsuchiura Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2116-3127","authenticated-orcid":false,"given":"Tadanori","family":"Nakata","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Tsuchiura Kyodo Hospital, Tsuchiura Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiki","family":"Ishizawa","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Tsuchiura Kyodo Hospital, Tsuchiura Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuo","family":"Sasano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Institute of Science Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Hachiya","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Tsuchiura Kyodo Hospital, Tsuchiura Ibaraki 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