Key result
Ablating non-PV triggers from low-voltage areas achieves similar AF-free survival to patients without triggers.
Why the study?
The pathophysiology of non-pulmonary vein triggers of AF is unclear, leading researchers to hypothesize an association between left atrial non-PV triggers and atrial tissue degeneration.
Are left atrial non-pulmonary vein triggers associated with low-voltage areas and atrial tissue degeneration in patients undergoing AF ablation?
Population
431 patients who underwent catheter ablation
Comparison
Patients with non-PV triggers vs without non-PV triggers
Design
Observational cohort study
Authors
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Non-PV LA triggers associated with low-voltage areas in non-paroxysmal AF; hypothesis-generating for degenerative substrate but should not yet change ablation practice.
Observational (n=431)
No
Are left atrial non-pulmonary vein triggers associated with low-voltage areas and atrial tissue degeneration in patients undergoing AF ablation?
Absolute Event Rate: 78% vs 79%
p-value: p=0.81
Left atrial non-pulmonary vein triggers of atrial fibrillation are associated with low-voltage areas, indicating that atrial degeneration may contribute to AF persistence.
Kawai et al. (2019) conducted an observational in Atrial Fibrillation (n=431). Catheter ablation targeting non-pulmonary vein (non-PV) triggers vs. Patients without non-PV triggers was evaluated on AF/AT recurrence-free survival at 2 years (p=0.81). Left atrial non-pulmonary vein triggers arose from low-voltage areas, and tailored ablation yielded similar 2-year AF-free survival (78%) compared to patients without non-PV triggers (79%).
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