ArticleJournal of cardiovascular development and disease2026
The Finding of Posterior Wall Low-Voltage Zones During Cryoballoon Pulmonary Vein Isolation Facilitated by Periprocedural Electroanatomical Mapping Is Associated with a Worse Ablation Outcome.
Article in Journal of cardiovascular development and disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe presence of left atrial fibrosis is a marker of advanced remodeling and is associated with a worse outcome after pulmonary vein isolation (PVI). Conventional fluoroscopy-only cryoballoon ablation (CBA) lacks this prognostic information. The addition of electroanatomical mapping (EAM) using the inner lumen spiral catheter allows accurate voltage assessment of the left atrial posterior wall. However, the value of the finding of posterior wall low-voltage zones (pwLVZs) is unknown. PURPOSE: To study the value of left atrial voltage maps during CBA by comparing clinical and procedural characteristics and clinical outcome between patients with and without pwLVZs.
methodsA cohort of 250 consecutive patients who underwent index CBA for atrial fibrillation was analyzed. All patients underwent pre- and post-procedural EAM using the Achieve
resultsPwLVZs were found in 41/250 (16.4%) of patients. Patients with pwLVZs were older (69.3 ± 8.5 vs. 64.2 ± 10.4;
conclusionsIn CBA facilitated by integrated EAM, pwLVZ was associated with older age, female sex, higher CHADS-VASc scores, obesity, structural heart disease and persistent AF. The finding of pwLVZs is predictive of a worse clinical outcome.
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