Ablating non-pulmonary vein triggers improves A-fib outcome

Ablating non-pulmonary vein triggers improves A-fib outcome

(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)

Copyright © 2017 HealthDay. All rights reserved.

Citation: Ablating non-pulmonary vein triggers improves A-fib outcome (2017, September 14) retrieved 13 June 2021 from https://medicalxpress.com/news/2017-09-ablating-non-pulmonary-vein-triggers-a-fib.html
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.
0 shares

Feedback to editors

User comments