What is the clinical evidence from this study?

Population: Left-sided accessory pathway without prior history of atrial fibrillation (n=35). Intervention: Induction of short-lasting atrial fibrillation vs. Baseline (before AF induction). Primary outcome: Induction of AF by pacing in the pulmonary veins (p=0.001).

What does this research mean for the field?

Short-lasting atrial fibrillation causes acute electrical remodeling in the pulmonary veins, significantly shortening effective refractory periods, slowing conduction, and increasing the inducibility of recurrent AF. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine whether short-lasting atrial fibrillation causes acute electrical remodeling in the pulmonary veins and atria of patients without a history of arrhythmia.

August 21, 2026Journal of the American College of CardiologyOpen Access

Atrial Fibrillation Begets Atrial Fibrillation in the Pulmonary Veins

Q: What are the key findings of this study?

Exposure to 15 minutes of induced atrial fibrillation significantly increased the subsequent inducibility of AF by pacing in the pulmonary veins from 14% at baseline to 49% (p=0.001).

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Key result

Fifteen minutes of induced AF increases subsequent pulmonary vein AF inducibility by ~250%.

P=0.001
n=35

Why the study?

AF is associated with electrical remodeling promoting arrhythmia maintenance in the atria, but it was unclear whether these electrical alterations also occur in the PVs.

Does short-lasting induced atrial fibrillation alter the electrophysiological properties of the atria and pulmonary veins in patients without prior atrial fibrillation?

Key Points

To determine whether short-lasting atrial fibrillation causes acute electrical remodeling in the pulmonary veins and atria of patients without a history of arrhythmia.
Enrolled 35 patients with left-sided accessory pathways and no prior atrial fibrillation history following successful catheter ablation (NCT00530608).
Measured effective refractory periods (ERPs) and conduction times in the right atrium, left atrium, and pulmonary veins before and after maintaining induced atrial fibrillation for 15 minutes.
Effective refractory periods decreased in all regions after 15 minutes of atrial fibrillation, with pulmonary veins showing a larger reduction (248 ± 27 ms to 211 ± 40 ms, p < 0.001) than the left atrium (233 ± 23 ms to 214 ± 20 ms, p = 0.004) and right atrium (226 ± 29 ms to 188 ± 20 ms, p = 0.003).
Conduction time significantly prolonged in the pulmonary veins (125 ± 33 ms to 159 ± 37 ms, p < 0.001), whereas left and right atrial conduction times remained unchanged (p = NS).
Atrial fibrillation inducibility increased from 14% at baseline to 49% after the 15-minute arrhythmia exposure (p = 0.001), predominantly triggered by pulmonary vein pacing.

Structured PICO

Does short-lasting induced atrial fibrillation alter the electrophysiological properties of the atria and pulmonary veins in patients without prior atrial fibrillation?

Population

35 patients with a left-sided accessory pathway and no prior history of atrial fibrillation undergoing successful ablation.

Intervention

Induction and maintenance of atrial fibrillation for 15 minutes following successful ablation of the accessory pathway.

Comparator

Baseline electrophysiological properties prior to atrial fibrillation induction.

Outcome

Effective refractory periods (ERPs) and conduction times of the right atrium, left atrium, and pulmonary veins.surrogate

Main Result

Absolute Event Rate: 49% vs 14%

p-value: p=0.001

Short-lasting atrial fibrillation induces rapid electrical remodeling that is significantly more pronounced in the pulmonary veins than the atria, supporting the concept that 'AF begets AF' specifically within the pulmonary veins.

Discussion

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Implication

Short AF episodes may promote PV arrhythmogenesis; extends "AF begets AF" to pulmonary veins but remains hypothesis-generating.

Cite This Study

Rostock et al. (2008) studied Left-sided accessory pathway without prior history of atrial fibrillation (n=35). Induction of short-lasting atrial fibrillation vs. Baseline (before AF induction) was evaluated on Induction of AF by pacing in the pulmonary veins (p=0.001). Exposure to 15 minutes of induced atrial fibrillation significantly increased the subsequent inducibility of AF by pacing in the pulmonary veins from 14% at baseline to 49% (p=0.001).

synapsesocial.com/papers/6a88c0c2f0c2079f0c0124db https://doi.org/10.1016/j.jacc.2008.02.059

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes Anticoagulation in AF

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Atrial Fibrillation Begets Atrial Fibrillation in the Pulmonary Veins

Key Points

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Topics

Atrial Fibrillation Begets Atrial Fibrillation in the Pulmonary Veins

Key Points

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider