Abstract 4141438: Predictors of Left Atrial Low Voltage Areas Were Different among Age Groups in Patients with Atrial Fibrillation Ablation

Background: Catheter ablation is a well-established treatment for atrial fibrillation (AF). Left atrial low-voltage areas (LVAs) is associated with atrial remodeling following the progression of atrial cardiomyopathy, and poor rhythm outcome after catheter ablation. However, the predictors of LVAs presence have not been fully elucidated in different age groups. Purpose: The purpose of this study was to investigate predictors of the prevalence of LVAs in different age groups. Methods: 1,488 (age, 69 ± 10 years; female, 501 [34%]) consecutive patients who underwent initial ablation were included. Age groups were divided into three groups, namely <60 years old (younger age, n=272), 60-75 years old (intermediate age, n=864), ≥75 years old (older age, n=352). The definition of LVAs was areas with a bipolar voltage of <0.5 mV covering ≥5 cm2 of left atrial surface. Multivariate logistic regression analysis was performed to investigate the clinical predictors of LVAs. Results: Of 1,488 patients, LVAs existed in 352 (24%) patients. In the younger age group, C-reactive protein (odds ratio [OR], 4.5; [95% confidence interval {CI}: 1.5-13], p = 0.006) and previous history of heart failure (OR, 5.6; [95% CI: 1.2-26], p = 0.027) were the independent predictors of LVAs. In the intermediate age group, female (OR, 3.8; [95% CI: 2.6-5.7], p < 0.001), persistent AF (OR, 2.6; [95% CI: 1.7-4.1], p < 0.001), lower body mass index (OR, 0.93; [95% CI: 0.88-0.98], p = 0.004), lower hemoglobin (OR, 0.81; [95% CI: 0.72-0.93], p = 0.002), C-reactive protein (OR, 1.4; [95% CI: 1.0 1-2.0], p = 0.047), diabetes mellitus (OR, 1.8; [95% CI: 1.1-2,8], p = 0.01), left atrial diameter (OR, 1.04; [95% CI: 1.01-1.1], p = 0.007) were the independent predictors of LVAs. In the older age group, female (OR, 2.3; [95% CI: 1.4-3.7], p = 0.01), persistent AF (OR, 3.1; [95% CI: 1.8-5.2], p < 0.001) and lower hemoglobin (OR, 0.83; [95% CI: 0.71-0.97], p = 0.017) were the independent predictors of LVAs. Conclusion: In patients with atrial fibrillation ablation, the independent predictors of LVAs were different among age groups.