Letter by Bartoletti et al Regarding Article, 'Ablation of Persistent Atrial Fibrillation Targeting Low-Voltage Areas With Selective Activation Characteristics'

We congratulate Jadidi et al1 on their interesting article, “Ablation of Persistent Atrial Fibrillation Targeting Low-Voltage Areas With Selective Activation Characteristics.” They prospectively enrolled 85 patients with persistent atrial fibrillation undergoing ablation with a stepwise approach. No further lesions beyond pulmonary vein isolation (PVI) were delivered in 23 (27%), who were in sinus rhythm at the start or reverted to sinus rhythm during PVI. In the remaining 62 patients, further lesions were delivered within low-voltage areas (LVA) in the left atrium or in their borders. They found that these 62 cases had higher success rates compared with PVI-only controls chosen from a historical population. A couple of observations are …