{
  "abstract": "Background Mechanical compression from the ascending aorta on the left atrial anterior wall (LAAW) can cause low voltage areas (LVAs), which are associated with a higher risk of atrial fibrillation (AF) recurrence after catheter ablation. This study investigates the AF recurrence rate post-LAAW complex fractionated atrial electrograms (CFAE) ablation or LAAW linear ablation in AF patients with aortic encroachment.Methods We retrospectively analysed AF patients who underwent first-time ablation between 2019 and 2023 in our department and had preablation cardiac CT scans. The impact of LAAW-LVAs and different LAAW ablation strategies on AF recurrence within 1-year postprocedure was evaluated.Results In total, 267 patients had both aortic encroachment and LAAW-LVAs. In the absence of LAAW ablation, patients with aortic encroachment had a significantly higher risk of AF recurrence compared with those without (adjusted HR (aHR): 2.29, 95% CI: 1.27 to 4.15, p=0.006). Patients receiving LAAW CFAE ablation had a higher recurrence rate than those receiving LAAW linear ablation (aHR: 3.29, 95% CI 1.42 to 7.63, p=0.006). Multivariable analysis identified that LAAW linear ablation was a strong independent predictor of reduced AF recurrence (HR: 0.13, 95% CI 0.06 to 0.28, p<0.001).Conclusions Aortic encroachment is a common and significant risk factor for AF recurrence after ablation. When LAAW-LVAs are present, performing LAAW linear ablation might be a highly effective strategy to reduce postablation AF recurrence.",
  "authors": [
    {
      "affiliations": [
        "Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China"
      ],
      "name": "Rui Zhang"
    },
    {
      "affiliations": [
        "Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China"
      ],
      "name": "Qian-Ji Che"
    },
    {
      "affiliations": [
        "Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China"
      ],
      "name": "Peng-Cheng Yao"
    },
    {
      "affiliations": [
        "Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China"
      ],
      "name": "Mu Chen"
    },
    {
      "affiliations": [
        "Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China"
      ],
      "name": "Qun-Shan Wang"
    },
    {
      "affiliations": [
        "Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China"
      ],
      "name": "Jian Sun"
    },
    {
      "affiliations": [
        "Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China"
      ],
      "name": "Wei Li"
    },
    {
      "affiliations": [
        "Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China"
      ],
      "name": "Peng-Pai Zhang"
    },
    {
      "affiliations": [
        "Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China"
      ],
      "name": "Bo Liu"
    },
    {
      "affiliations": [
        "Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China"
      ],
      "name": "Yi-Gang Li"
    }
  ],
  "title": "Left atrial anterior wall ablation reduces the recurrence of atrial fibrillation in patients with aortic encroachment",
  "uid": "dd35a0d7-ba14-50a8-8be1-4040bc93472b"
}