4.2. LACV and AF recurrence
LACVs, conduction times, and conduction distances between patients with and without AF recurrence are compared in Figure 2. Left atrial conduction time was longer, and anterior and posterior LACVs were slower in patients with AF recurrence than in those without. The anterior route demonstrated a shorter distance and slower LACV than the posterior route irrespective of AF recurrence. Anterior and posterior LACVs showed moderate linear correlation (R = 0.70, p<0.0001; supplementary figure 1). ROC curve analysis demonstrated that anterior LACV with a cut-off value of 0.87 m/s best predicted AF recurrence, with sensitivity of 87%, specificity of 81%, and predictive accuracy of 84% (Supplementary figure 2). AF-recurrence-free rate was significantly lower in patients with a slow anterior LACV < 0.87 m/s than in those with an LACV ≥ 0.87 m/s (Figure 3). Example cases of normal and slow LACV are presented in the supplementary movie. Multivariate analysis incorporating baseline characteristics and left atrial mapping data revealed that a slow anterior LACV of < 0.87 m/s was the only independent predictor of AF recurrence, with a hazard ratio of 11.8 (6.36 – 22.0) (Table 3). AF recurrence-free rate was significantly higher in patients with an anterior LACV < 0.87 m/s than in those with ≥ 0.87 m/s. Clinical factors associated with a slow anterior LACV (< 0.87 m/s) are explored in Supplementary table. Female, persistent AF, and large left atrium were related to a slow anterior LACV. Multivariate analysis revealed that female gender was the only independent predictor of having a slow anterior LACV.