{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:24:51Z","timestamp":1792686291979,"version":"4.5.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,7,7]]},"abstract":"\n Background<\/jats:title>\n \n The efficacy of low\u2010voltage\u2010area (\n LVA<\/jats:styled-content>\n ) ablation has not been well determined. This study aimed to investigate the efficacy of\n LVA<\/jats:styled-content>\n ablation in addition to pulmonary vein isolation on rhythm outcomes in patients with paroxysmal atrial fibrillation (\n AF<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n VOLCANO (Catheter Ablation Targeting Low\u2010Voltage Areas After Pulmonary Vein Isolation in Paroxysmal Atrial Fibrillation Patients) trial included paroxysmal AF patients undergoing initial AF ablation. Of 398 patients in whom a left atrial voltage map was obtained after pulmonary vein isolation, 336 (85%) had no\n LVA<\/jats:styled-content>\n (group A). The remaining 62 (15%) patients with\n LVA<\/jats:styled-content>\n s were randomly allocated to undergo\n LVA<\/jats:styled-content>\n ablation (group B, n=30) or not (group C, n=32) in a 1:1 fashion. Primary end point was 1\u2010year\n AF<\/jats:styled-content>\n \u2010recurrence\u2010free survival rate. No adverse events related to\n LVA<\/jats:styled-content>\n ablation occurred. Procedural (124\u00b140 versus 95\u00b133\u00a0minutes,\n P<\/jats:italic>\n =0.003) and fluoroscopic times (29\u00b111 versus 24\u00b18\u00a0minutes,\n P<\/jats:italic>\n =0.034) were longer in group B than group C. Patients with\n LVA<\/jats:styled-content>\n s demonstrated lower\n AF<\/jats:styled-content>\n \u2010recurrence\u2010free survival rates (88%) than those without\n LVA<\/jats:styled-content>\n (B, 57%,\n P<\/jats:italic>\n <0.0001; C, 53%,\n P<\/jats:italic>\n <0.0001). However,\n LVA<\/jats:styled-content>\n ablation in addition to pulmonary vein isolation did not impact\n AF<\/jats:styled-content>\n \u2010recurrence\u2010free survival rate (group B versus C,\n P<\/jats:italic>\n =0.67).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The presence of\n LVA<\/jats:styled-content>\n was a strong predictor of\n AF<\/jats:styled-content>\n recurrence after pulmonary vein isolation in patients with paroxysmal\n AF<\/jats:styled-content>\n . However,\n LVA<\/jats:styled-content>\n ablation had no beneficial impact on 1\u2010year rhythm outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Registration<\/jats:title>\n \n URL:\n https:\/\/www.umin.ac.jp\/ctr<\/jats:ext-link>\n ; Unique identifier: UMIN000023403.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.120.015927","type":"journal-article","created":{"date-parts":[[2020,6,24]],"date-time":"2020-06-24T05:28:39Z","timestamp":1592976519000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":110,"title":["Additional Low\u2010Voltage\u2010Area Ablation in Patients With Paroxysmal Atrial Fibrillation: Results of the Randomized Controlled VOLCANO Trial"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5566-466X","authenticated-orcid":false,"given":"Masaharu","family":"Masuda","sequence":"first","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsutoshi","family":"Asai","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Iida","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Ishihara","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyonori","family":"Nanto","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kanda","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Tsujimura","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shota","family":"Okuno","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Hata","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiaki","family":"Mano","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eux274"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.113.001251"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.115.003382"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12870"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.115.002962"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13019"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.12.089"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13321"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eux310"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.117.005405"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.12.029"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.07.003"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.03.009"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13524"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euw338"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.015927","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:36:18Z","timestamp":1715585778000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.015927"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,7]]},"references-count":15,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2020,7,7]]}},"alternative-id":["10.1161\/JAHA.120.015927"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.015927","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,7]]},"assertion":[{"value":"2020-03-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e015927"}}