Ablating non-pulmonary vein triggers improves A-fib outcome

September 14, 2017

(HealthDay)—For patients with atrial fibrillation (AF) with two or more failed pulmonary vein isolation (PVI) procedures, ablating non-PV triggers is associated with improved outcomes, according to a study published online Aug. 25 in the Journal of Cardiovascular Electrophysiology.

Sanghamitra Mohanty, M.D., from St. David's Medical Center in Austin, Texas, and colleagues reported procedural findings and outcome in 305 AF patients referred after two or more failed PVI procedures. PV reconnection and non-PV triggers were identified using high-dose isoproterenol challenge. Based on the operator's discretion, non-PV triggers were ablated during the index procedure; non-PV triggers were ablated in all at the repeat procedure.

The researchers found that 226 patients had PV reconnection, and non-PV triggers were identified or empirically isolated in 285 patients during the index procedure. Sixty percent of patients were recurrence-free off antiarrhythmic drugs (AAD) at follow-up. The success rate was 81 percent with and 8 percent without non-PV ablation (P < 0.0001). One hundred four patients underwent repeat procedure; all had non-PV trigger ablation. At one-year, in the non-PV ablation group, 90 percent were arrhythmia free off-AAD, compared with 72 percent among those who did not receive non-PV trigger ablation at the index procedure (P = 0.035). After the index and repeat , the success rates of empirical and coronary sinus isolation were 78.5 and 82 percent, respectively.

"In experiencing AF recurrence after multiple failed PVI, despite PV reconnection, non-PV triggers were found to be responsible for AF maintenance in the majority and ablating those triggers increased ablation-success," the authors write.

Explore further: Multiple repeat procedures seem beneficial in A-fib recurrence

More information: Abstract
Full Text (subscription or payment may be required)

Related Stories

Multiple repeat procedures seem beneficial in A-fib recurrence

May 4, 2015
(HealthDay)—Most patients experience benefit after three or more catheter ablation procedures for atrial fibrillation (AF), according to a study published in the April issue of the Journal of Cardiovascular Electrophysiology.

Low incidence of adverse events for A-fib catheter ablation

September 4, 2017
(HealthDay)—The incidence of adverse events (AEs) is low for patients undergoing catheter ablation (CA) for atrial fibrillation (AF), according to a study published online Aug. 30 in JACC: Clinical Electrophysiology.

Treating left atrial appendage could dampen long standing persistent AF

August 30, 2015
In patients with long-standing persistent atrial fibrillation (AF) despite standard treatment, additional electrical isolation of an area called the left atrial appendage (LAA) can improve freedom from AF without increasing ...

Benefit of aspirin after A-fib ablation questioned

September 4, 2017
(HealthDay)—For atrial fibrillation (AF) ablation patients undergoing their index ablation, long-term aspirin therapy is associated with increased rates of bleeding and may not lower risk of stroke, according to a study ...

Poor outcome for rotor ablation in A-fib in randomized trial

May 9, 2016
(HealthDay)—For patients with non-paroxysmal atrial fibrillation (AF), rotor-only ablation is associated with a poor outcome compared with other ablation strategies, according to a randomized study published online May ...

Robotic navigation noninferior for CVPI in atrial fibrillation

June 29, 2017
(HealthDay)—For patients with atrial fibrillation (AF) undergoing circumferential pulmonary vein isolation (CPVI), use of robotic navigation (RN) systems is noninferior to manual ablation (MN), according to a study published ...

Recommended for you

Could this protein protect people against coronary artery disease?

November 17, 2017
The buildup of plaque in the heart's arteries is an unfortunate part of aging. But by studying the genetic makeup of people who maintain clear arteries into old age, researchers led by UNC's Jonathan Schisler, PhD, have identified ...

New model estimates odds of events that trigger sudden cardiac death

November 16, 2017
A new computational model of heart tissue allows researchers to estimate the probability of rare heartbeat irregularities that can cause sudden cardiac death. The model, developed by Mark Walker and colleagues from Johns ...

Popular e-cigarette liquid flavorings may change, damage heart muscle cells

November 16, 2017
Chemicals used to make some popular e-cigarette liquid flavorings—including cinnamon, clove, citrus and floral—may cause changes or damage to heart muscle cells, new research indicates.

Possible use for botulinum toxin to treat atrial fibrillation

November 16, 2017
From temporarily softening wrinkles to easing migraines, botulinum toxin has become a versatile medical remedy because of its ability to block nerve signals that can become bothersome or risky.

Proteome of the human heart mapped for the first time

November 15, 2017
A healthy heart beats about two billion times during a lifetime, thanks to the interplay of more than 10,000 proteins. Researchers from the Max Planck Institute of Biochemistry (MPIB) and the German Heart Centre at the Technical ...

First transcatheter implant for diastolic heart failure successful

November 15, 2017
Results presented today at the American Heart Association Scientific Sessions and published in Circulation show that a new device designed to treat diastolic heart failure is safe and effective. The first patient in the randomized, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.