Limitations
Several limitations of this study warrant mention. First, the definition of low-voltage areas (areas with a voltage < 0.5 mV covering 5.0 cm2 of the left atrial surface) was somewhat arbitrary. Second, some patients in group A and C underwent LVA ablation, because there was no protocol strategy for repeat ablation. Third, AF recurrence after discharge was quantified on the basis of patient symptoms, giving rise to the possibility that asymptomatic episodes of AF might have been missed. Fourth, some patients died or were lost to follow-up before end of the 2-year follow-up period after initial ablation. Finally, the small sample size might have biased the patient characteristics and limited the statistical accuracy of our results. Multicenter randomized controlled trials in sufficient numbers of patients are warranted.