What is the clinical evidence from this study?

Study design: Cohort. Population: Paroxysmal atrial fibrillation without low-voltage areas (n=158). Intervention: Transition zone burden vs. Lower transition zone burden. Primary outcome: Recurrence of any episode of atrial tachyarrhythmia lasting ≥ 30 s after a 3-month blanking period (HR 1.065, 95% CI 1.034-1.098, p=< 0.0001).

What does this research mean for the field?

In elderly patients with paroxysmal atrial fibrillation without low-voltage areas, a higher transition zone burden correlates with slower left atrial conduction velocity and independently predicts arrhythmia recurrence after circumferential pulmonary vein isolation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the relationship of left atrial transition zone burden with left atrial conduction velocity and arrhythmia recurrence after catheter ablation in elderly patients with paroxysmal atrial fibrillation lacking low-voltage areas.

September 3, 2026Clinical CardiologyOpen Access

Association of Transition Zone Burden With Recurrence in Elderly Patients With Paroxysmal Atrial Fibrillation Without Low‐Voltage Areas

Q: What are the key findings of this study?

Higher transition zone burden independently predicted atrial tachyarrhythmia recurrence following circumferential pulmonary vein isolation (adjusted HR 1.065; 95% CI 1.034-1.098; p<0.0001).

Q: What does this research mean for the field?

In elderly patients with paroxysmal atrial fibrillation without low-voltage areas, a higher transition zone burden correlates with slower left atrial conduction velocity and independently predicts arrhythmia recurrence after circumferential pulmonary vein isolation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the relationship of left atrial transition zone burden with left atrial conduction velocity and arrhythmia recurrence after catheter ablation in elderly patients with paroxysmal atrial fibrillation lacking low-voltage areas.

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Key result

Higher transition zone burden predicts ~7% greater atrial tachyarrhythmia recurrence risk after PVI.

HR 1.065
95% CI 1.034-1.098
P<0.0001
n=158

Why the study?

Does higher transition zone burden predict atrial tachyarrhythmia recurrence in elderly patients with paroxysmal AF without low-voltage areas undergoing CPVI?

Population

158 elderly patients with paroxysmal atrial fibrillation without low-voltage areas undergoing…

Comparison

Higher transition zone burden vs Lower transition zone (TZ) burden (<5%)

Design

Cohort

Follow-up

mean 24.9 months

Authors

YWYuxuan WangChongqing Medical University YQYue QiuNantong University HWHaojun WangSuizhou Central Hospital

Discussion

Member takes

Implication

May support enhanced post-ablation monitoring in high-burden patients; hypothesis-generating for transition zone modification trials.

Key Points

To evaluate the relationship of left atrial transition zone burden with left atrial conduction velocity and arrhythmia recurrence after catheter ablation in elderly patients with paroxysmal atrial fibrillation lacking low-voltage areas.
Enrolled 158 elderly patients (mean age 69.7 ± 3.8 years) with paroxysmal atrial fibrillation and no low-voltage areas undergoing circumferential pulmonary vein isolation.
Classified patients into three groups based on left atrial transition zone burden (<5%, 5%–15%, and >15%) defined by bipolar voltage between 0.5 and 1.0 mV.
Assessed left atrial conduction velocity and monitored patients for atrial tachyarrhythmia recurrence (episodes ≥30 seconds after a 3-month blanking period) over a mean follow-up of 24.9 months.
Higher transition zone burden was significantly associated with decreased anterior left atrial conduction velocity (1.52 ± 0.36 m/s in <5% vs. 1.21 ± 0.27 m/s in 5%–15% vs. 1.02 ± 0.25 m/s in >15%, p < 0.0001).
Arrhythmia recurrence occurred in 40 of 158 patients (25.3%), with recurrent patients showing higher median transition zone burden than nonrecurrent patients (15.4% [IQR 7.2–22.4] vs. 8.2% [IQR 3.5–14.3], p < 0.0001).
Transition zone burden remained an independent predictor of post-ablation recurrence in multivariable Cox regression (adjusted HR 1.065, 95% CI 1.034–1.098, p < 0.0001).

Study Design

Type

Cohort (n=158)

Structured PICO

Does higher transition zone burden predict atrial tachyarrhythmia recurrence in elderly patients with paroxysmal AF without low-voltage areas undergoing CPVI?

Population

158 elderly patients (mean age 69.7 years) with paroxysmal atrial fibrillation without low-voltage areas undergoing circumferential pulmonary vein isolation, followed for a mean of 24.9 months.

Exposure

Higher transition zone (TZ) burden (>15% or 5%-15%)

Comparator

Lower transition zone (TZ) burden (<5%)

Outcome

Recurrence of any episode of atrial tachyarrhythmia (ATA) lasting ≥ 30 s after a 3-month blanking periodhard clinical

Main Result

Hazard Ratio: 1.065 (95% CI 1.034–1.098)

p-value: p=< 0.0001

Higher transition zone burden is correlated with slower left atrial conduction velocity and independently predicts atrial tachyarrhythmia recurrence after pulmonary vein isolation in elderly patients with paroxysmal AF without low-voltage areas.

Cite This Study

Wang et al. (2026) conducted a cohort in Paroxysmal atrial fibrillation without low-voltage areas (n=158). Transition zone burden vs. Lower transition zone burden was evaluated on Recurrence of any episode of atrial tachyarrhythmia lasting ≥ 30 s after a 3-month blanking period (HR 1.065, 95% CI 1.034-1.098, p=< 0.0001). Higher transition zone burden independently predicted atrial tachyarrhythmia recurrence following circumferential pulmonary vein isolation (adjusted HR 1.065; 95% CI 1.034-1.098; p<0.0001).

synapsesocial.com/papers/6a9935f3636c6408cfa7ea2f https://doi.org/10.1002/clc.70435

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Association of Transition Zone Burden With Recurrence in Elderly Patients With Paroxysmal Atrial Fibrillation Without Low‐Voltage Areas

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Association of Transition Zone Burden With Recurrence in Elderly Patients With Paroxysmal Atrial Fibrillation Without Low‐Voltage Areas

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider