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.