Left atrial low voltage areas and heart failure in patients with atrial fibrillation: Implication of the atrial myopathy

Aims Atrial fibrillation (AF) and heart failure (HF) affect each other and are often co‐morbid. The fact that HF development is not uncommon even after ablation suggests that we need a deeper understanding of the pathology of these conditions. Atrial myocardial degeneration is an underlying factor in AF patients and may be associated with HF development after ablation. This study aimed to investigate the impact of low‐voltage areas (LVAs) on HF prognosis after AF ablation. Methods and results This observational study included 1481 consecutive patients undergoing initial ablation for AF. Left atrial LVAs were defined as regions with a bipolar peak‐to‐peak voltage of