Discussion
This observational study followed up patients enrolled in the randomized
controlled VOLCANO trial. Four main findings were recognized: (1)
Patients with LVAs at the initial ablation experienced more frequent
long-term (> 2 years) AF/AT recurrence and loss of sinus
rhythm on final follow-up ECG than those without; (2) an ablation
strategy targeting LVA failed to show a beneficial impact on long-term
AF/AT recurrence after single and multiple ablations; (3) spontaneously
developed or pacing-induced regular ATs were more often observed in
patients with LVAs than in those without; and (4) LVA ablation increased
AT development at repeat ablation, especially biatrial tachycardia after
anterior-septal LVA ablation.