Influence of the left atrial contact areas on fixed low‐voltage zones during atrial fibrillation and sinus rhythm in persistent atrial fibrillation

Background Atrial low‐voltage zones (LVZ) are suggested as important factors for maintaining persistent atrial fibrillation (PsAF). The relationship between LVZs and left atrial (LA) contact areas (CoAs) is still unclear. Objective To assess whether CoA regions were involved in atrial substrate properties maintaining PsAF. Methods A total of 50 patients with PsAF (36 long‐lasting) were analyzed. Three representative CoA detection areas (ascending aorta‐anterior‐LA, descending aorta‐left pulmonary vein antrum, and vertebrae‐posterior‐LA) were registered on the mapping geometry. Electrograms during AF and sinus rhythm (SR) were acquired, and the fractionated electrograms (CFE; 5% of the total LA surface area). Patients with long‐lasting PsAF versus PsAF had larger CoA areas (7.7 ± 3.0 vs. 4.5 ± 2.5cm2, P