{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:28:46Z","timestamp":1791829726914,"version":"4.3.4"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T00:00:00Z","timestamp":1668643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>This study aimed to evaluate the efficacy of low-voltage area (LVA)-guided substrate modification catheter ablation in patients with atrial fibrillation (AF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Systematic searches of the PubMed, EMBASE, and Cochrane databases were performed from inception to July 2022 for all available studies. The effect estimates were combined with the Mantel\u2013Haenszel random-effects model. Subgroup analyses, sensitivity analysis, and meta-regression were conducted to explore the sources of statistical heterogeneity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 16 studies involving 1942 subjects (mean age: 61 \u00b1 10 years, 69% male) were identified. All studies included patients with paroxysmal AF, non-paroxysmal AF, or both. At a mean follow-up of 18.9 months, patients who underwent LVA-guided substrate modification ablation had significantly higher freedom from all-atrial tachycardia recurrence than patients who underwent control ablation [67.7% vs. 48.9%, risk ratios (RR) 0.64, 95% confidence interval (CI) 0.55\u20130.76, <jats:italic>P<\/jats:italic> &amp;lt; 0.001], with 36% relative risk and 18.7% absolute risk reductions in all-atrial tachycardia recurrence. Subgroup analysis based on AF types demonstrated that the decreased risk of all-atrial tachycardia recurrence was present predominantly in non-paroxysmal AF compared with paroxysmal AF (RR 0.60, 95% CI 0.52\u20130.69 vs. RR 0.96, 95% CI 0.81\u20131.13).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Low-voltage area-guided substrate modification ablation combined with PVI appears to have a significant beneficial effect of improving freedom from all-atrial tachycardia recurrence, especially in patients with non-paroxysmal AF.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.993790","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T15:22:55Z","timestamp":1668698575000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Efficacy of left atrial low-voltage area-guided catheter ablation of atrial fibrillation: An updated systematic review and 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