Key result
Regional ganglionated plexus ablation eliminates isolated pulmonary vein rapid firing, adding potential benefit to PVI.
Why the study?
Additional ganglionated plexus ablation may provide benefit beyond circumferential pulmonary vein isolation to reduce atrial fibrillation recurrence.
Case Report
May indicate residual GP triggers after PV isolation; hypothesis-generating for adjunctive GP ablation in AF.
Atrial fibrillation (AF) was initiated by rapid firing from left superior pulmonary vein (PV) by administration of isoproterenol (ISP) and adenosine triphosphate (ATP) before ablation. After successful isolation of all PVs, ISP and ATP were administered again. PVs were still isolated but an episode of rapid firing was observed inside the left PV isolation line during sinus rhythm. Radiofrequency energy was then delivered to the areas of superior left ganglionated plexus (GP) and inferior left GP. Then, PV firing could no longer be initiated. It suggests additional GP ablation may have additional benefit to circumferential PV isolation, to reduce the incidence of AF recurrence.
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Jiang et al. (2011) conducted a case report in Atrial fibrillation. Regional Ganglionated Plexus (GP) Ablation was evaluated on Elimination of rapid firing in an electrically isolated pulmonary vein. Regional ganglionated plexus ablation eliminated rapid firing inside an electrically isolated pulmonary vein, suggesting potential additional benefit to circumferential pulmonary vein isolation.
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