In patients with AF, left atrial low-voltage areas (LVAs) during initial AF ablation procedures have an impact on the occurrence of very late recurrence of AF (VLRAF). For a study published in the Journal of Cardiovascular Electrophysiology,  investigators analyzed 1,001 patients with AF undergoing initial ablation procedures. Among participants, 248 had a late recurrence of AF (LRAF), defined as recurrence within 3-12 months after ablation, during a 1-year follow-up. In 711 patients without LRAF who were followed for more than 1 year, the occurrence of VLRAF was monitored. In 123 patients, VLRAF more than 1 year after the initial ablation was detected during a median follow-up of 25 months. Independent predictors of VLRAF were female sex, left atrial diameter, the existence of LVAs, and early recurrence of AF. AF-free survival rate was considerably lower in patients with LVAs than in those without LVAs within 1 year and on more than 1 year follow-up. In addition, VLRAF occurred more frequently in patients with LVAs.