Distribution Patterns of Paroxysmal Atrial Fibrillation Triggers and Catheter Ablation Success Rates

ABSTRACT Objective Investigate the distribution of triggers in paroxysmal atrial fibrillation (PAF) patients and assess the efficacy of circumferential pulmonary vein isolationI (CPVI) combined with non‐pulmonary veins (PV) trigger ablation over 1 year. Methods This prospective study included 130 PA...

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Main Authors: Dongsheng Zhao, Yan Dong, Qiushi Chen, Fengxiang Zhang, Koulong Zheng
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Annals of Noninvasive Electrocardiology
Subjects:
Online Access:https://doi.org/10.1111/anec.70065
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author Dongsheng Zhao
Yan Dong
Qiushi Chen
Fengxiang Zhang
Koulong Zheng
author_facet Dongsheng Zhao
Yan Dong
Qiushi Chen
Fengxiang Zhang
Koulong Zheng
author_sort Dongsheng Zhao
collection DOAJ
description ABSTRACT Objective Investigate the distribution of triggers in paroxysmal atrial fibrillation (PAF) patients and assess the efficacy of circumferential pulmonary vein isolationI (CPVI) combined with non‐pulmonary veins (PV) trigger ablation over 1 year. Methods This prospective study included 130 PAF patients undergoing initial catheter ablation. A standardized protocol was applied before CPVI, followed by ablation targeting non‐PV triggers. Ablation success was marked by the inability to induce atrial fibrillation (AF) or related arrhythmias. Patients underwent Holter monitoring at intervals post‐surgery, culminating in a 7‐day exam at 12 months. Results Atrial fibrillation (AF) was induced in 88 patients (67.0%), with 94 foci identified. The left pulmonary vein was a common source, but the superior vena cava emerged as the most prevalent non‐PV site. The 1‐year success rate was 86.0%, with no significant differences in success rates among trigger types. However, non‐PV triggers were linked to lower recurrence rates post‐surgery (HR 0.27, 95% CI 0.08–0.96, p = 0.04). Conclusion The study found that the combination of drug stimulation and high‐frequency atrial stimulation before CPVI significantly boosted AF induction rates and revealed a high incidence of non‐PV triggers. Effective intraoperative induction and accurate identification of non‐PV triggers, particularly in the superior vein cava (SVC), contributed to a substantial reduction in postoperative recurrence rates. This approach suggests a potential strategy for improving outcomes in PAF treatment.
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spelling doaj-art-8e0a24e23abd49889f4b2f0484945f592025-08-20T02:10:42ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2025-03-01302n/an/a10.1111/anec.70065Distribution Patterns of Paroxysmal Atrial Fibrillation Triggers and Catheter Ablation Success RatesDongsheng Zhao0Yan Dong1Qiushi Chen2Fengxiang Zhang3Koulong Zheng4Department of Cardiology The Second Affiliated Hospital of Nantong University Nantong People's Republic of ChinaDepartment of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu People's Republic of ChinaDepartment of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu People's Republic of ChinaDepartment of Cardiology The First Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu People's Republic of ChinaDepartment of Cardiology The Second Affiliated Hospital of Nantong University Nantong People's Republic of ChinaABSTRACT Objective Investigate the distribution of triggers in paroxysmal atrial fibrillation (PAF) patients and assess the efficacy of circumferential pulmonary vein isolationI (CPVI) combined with non‐pulmonary veins (PV) trigger ablation over 1 year. Methods This prospective study included 130 PAF patients undergoing initial catheter ablation. A standardized protocol was applied before CPVI, followed by ablation targeting non‐PV triggers. Ablation success was marked by the inability to induce atrial fibrillation (AF) or related arrhythmias. Patients underwent Holter monitoring at intervals post‐surgery, culminating in a 7‐day exam at 12 months. Results Atrial fibrillation (AF) was induced in 88 patients (67.0%), with 94 foci identified. The left pulmonary vein was a common source, but the superior vena cava emerged as the most prevalent non‐PV site. The 1‐year success rate was 86.0%, with no significant differences in success rates among trigger types. However, non‐PV triggers were linked to lower recurrence rates post‐surgery (HR 0.27, 95% CI 0.08–0.96, p = 0.04). Conclusion The study found that the combination of drug stimulation and high‐frequency atrial stimulation before CPVI significantly boosted AF induction rates and revealed a high incidence of non‐PV triggers. Effective intraoperative induction and accurate identification of non‐PV triggers, particularly in the superior vein cava (SVC), contributed to a substantial reduction in postoperative recurrence rates. This approach suggests a potential strategy for improving outcomes in PAF treatment.https://doi.org/10.1111/anec.70065atrial fibrillation inductionnon‐PV triggerparoxysmal atrial fibrillationprognosistrigger ablation
spellingShingle Dongsheng Zhao
Yan Dong
Qiushi Chen
Fengxiang Zhang
Koulong Zheng
Distribution Patterns of Paroxysmal Atrial Fibrillation Triggers and Catheter Ablation Success Rates
Annals of Noninvasive Electrocardiology
atrial fibrillation induction
non‐PV trigger
paroxysmal atrial fibrillation
prognosis
trigger ablation
title Distribution Patterns of Paroxysmal Atrial Fibrillation Triggers and Catheter Ablation Success Rates
title_full Distribution Patterns of Paroxysmal Atrial Fibrillation Triggers and Catheter Ablation Success Rates
title_fullStr Distribution Patterns of Paroxysmal Atrial Fibrillation Triggers and Catheter Ablation Success Rates
title_full_unstemmed Distribution Patterns of Paroxysmal Atrial Fibrillation Triggers and Catheter Ablation Success Rates
title_short Distribution Patterns of Paroxysmal Atrial Fibrillation Triggers and Catheter Ablation Success Rates
title_sort distribution patterns of paroxysmal atrial fibrillation triggers and catheter ablation success rates
topic atrial fibrillation induction
non‐PV trigger
paroxysmal atrial fibrillation
prognosis
trigger ablation
url https://doi.org/10.1111/anec.70065
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