Segmental analysis of left atrial substrate severity predictors in patients undergoing persistent atrial fibrillation ablation
By
Edoardo Cecchini
Gennaro Fabiano
Paola Liporace
Paolo Francesco Sorrenti
Giuseppe Campagna
Emmanuel Fabiano
Jacopo Colella
Alessandro Di Vilio
Giuseppe Indellicati
Simona Brogneri
Diego Sangiorgi
Andrea Petretta
Saverio Iacopino
July 6, 2026
Clinical Scorecard: Assessment of Predictors for Left Atrial Substrate Severity in Patients Undergoing Ablation for Persistent Atrial Fibrillation
At a Glance
Category Detail
Condition Persistent Atrial Fibrillation Key Mechanisms Left atrial structural and electrical remodeling Target Population Patients undergoing ablation for drug-refractory persistent AF Care Setting Single-center retrospective study
Key Highlights
Higher mean percentage of very low-voltage zones predicts recurrences (HR 1.025; p = 0.008) Protective effect of posterior-wall epicardial adipose tissue (HR 0.267; p = 0.007) Very low bipolar voltage burden in the roof is associated with increased risk of recurrence (HR 1.024; p = 0.026) Freedom from recurrence at 12 months was 70.6% Study utilized AI-based platform for detailed analyses of LA substrate Guideline-Based Recommendations
Diagnosis
Assessment of left atrial substrate anomalies using bipolar voltage and other predictors Management
Tailored ablation procedures based on individual atrial substrate characteristics Monitoring & Follow-up
Follow-up for freedom from recurrence post-ablation Risks
Empirical additional ablation lesions may lead to adverse outcomes Patient & Prescribing Data
69 consecutive patients with drug-refractory persistent AF
Comprehensive characterization of LA substrate may improve ablation outcomes
Clinical Best Practices
Utilize high-density electroanatomic mapping for LA assessment Incorporate AI-assisted analysis for substrate evaluation Consider segment-specific characteristics in ablation strategy Related Resources & Content
