{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:55:50Z","timestamp":1790664950610,"version":"4.1.0"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T00:00:00Z","timestamp":1649721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>\n                    Pulmonary vein isolation has become a cornerstone treatment for catheter ablation of atrial fibrillation (AF). Recent reports show that additional ablation targeting low-voltage zones reduces AF recurrence. However, the pre-procedural predictors of low-voltage zones remain elusive. We retrospectively enrolled 359 patients (mean age 63.7 \u00b1 10.8 years; 73 females; and 149 had persistent atrial fibrillation) who underwent catheter ablation for AF and left atrial (LA) voltage mapping during sinus rhythm or atrial pacing. Low-voltage zones were defined as area of &gt; 5 cm\n                    <jats:sup>2<\/jats:sup>\n                    with a bipolar electrogram amplitude of &lt; 0.50 mV. Overall, 51 (14.2%) patients had low-voltage zones. Patients with low-voltage zones were older (67.9 \u00b1 9.9 vs. 63.0 \u00b1 10.8 years;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.003), predominantly female (33.3% vs. 18.2%;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.013), had higher prevalence of dilated cardiomyopathy (DCM) (11.8% vs. 1.6%;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.002) and hypertrophic cardiomyopathy (HCM) (9.8% vs. 2.6%;\n                    <jats:italic>P<\/jats:italic>\n                    = 0.025), and had larger LA volumes (153.6 \u00b1 46.4 vs. 117.7 \u00b1 67.8 mL;\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001) than those without low-voltage zones. Multivariate logistic regression analysis revealed that age (OR 1.060; 95% CI 1.022\u20131.101,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.002), female sex (OR 2.978; 95% CI 1.340\u20136.615,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.007), DCM (OR 8.341; 95% CI 1.381\u201350.372,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.021), HCM (OR 5.044; 95% CI 1.314\u201319.363,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.018), persistent AF (OR 4.188; 95% CI 1.928\u20139.100,\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001), and larger LA volume (OR 3.215; 95% CI 1.378\u20137.502,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.007) were independently associated with the presence of low-voltage zones. Patient age, female sex, DCM, HCM, persistent AF and larger LA volume may predict the presence of low-voltage zones and could be useful in selecting the appropriate ablation strategy for AF.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0266939","type":"journal-article","created":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T14:05:20Z","timestamp":1649772320000},"page":"e0266939","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":17,"title":["Pre-procedural predictors of left atrial low-voltage zones in patients undergoing catheter ablation of atrial fibrillation"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5521-5189","authenticated-orcid":true,"given":"Takenori","family":"Ikoma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihisa","family":"Naruse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaro","family":"Kaneko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoaki","family":"Sakakibara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6466-9457","authenticated-orcid":true,"given":"Taro","family":"Narumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Sano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Mogi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6934-7932","authenticated-orcid":true,"given":"Kenichiro","family":"Suwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayato","family":"Ohtani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masao","family":"Saotome","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Urushida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Maekawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,4,12]]},"reference":[{"key":"pone.0266939.ref001","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS).","author":"G Hindricks","year":"2020","journal-title":"Eur Heart J"},{"issue":"5","key":"pone.0266939.ref002","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/S0002-9343(02)01236-6","article-title":"A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew\/Paisley study","volume":"113","author":"S Stewart","year":"2002","journal-title":"The American journal of medicine"},{"issue":"9989","key":"pone.0266939.ref003","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/S0140-6736(14)61774-8","article-title":"50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study","volume":"386","author":"RB Schnabel","year":"2015","journal-title":"Lancet (London, England)."},{"issue":"3","key":"pone.0266939.ref004","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1093\/europace\/euu376","article-title":"Radiofrequency ablation vs. antiarrhythmic drug therapy as first line treatment of symptomatic atrial fibrillation: systematic review and meta-analysis.","volume":"17","author":"A Hakalahti","year":"2015","journal-title":"Europace: European pacing, arrhythmias, and cardiac electrophysiology: journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology"},{"issue":"3","key":"pone.0266939.ref005","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1093\/europace\/eux008","article-title":"Very long-term outcome following transcatheter ablation of atrial fibrillation. 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