Differences in the Atrial Electrophysiological Properties Between Vagal and Sympathetic Types of Atrial Fibrillation

Abstract

There are better electrical properties and a smaller LA volume in patients with vagal-type AF. In contrast, the LA substrate is worse, and coexisting non-PV triggers and recurrence following ablation are more prevalent in patients with the sympathetic-type AF.

Importance of non–pulmonary vein triggers ablation to achieve long-term freedom from paroxysmal atrial fibrillation in patients with low ejection fraction

“…[12][13][14][15][16][17][18] Furthermore, it is known that non-PV triggers are associated with a larger LA and worse LA substrate. 24,25 This is confirmed by our study: at baseline, larger LA and scar were more prevalent in patients with LVSD than those of patients without LVSD.…”

Impact of Catheter Ablation for Paroxysmal Atrial Fibrillation in Patients With Sick Sinus Syndrome – Important Role of Non-Pulmonary Vein Foci –

“…It is known that non-PV foci are associated with a large atrium and worse atrial substrate. 20, 22 In the present study, there was a tendency toward larger LA dimension in SSS patients than in those without SSS. Although we did not evaluate atrial voltage or scarring, Akoum et al reported that significant atrial fibrosis in the right atrium (RA) and LA quantified using late gadolinium enhancement-magnetic resonance imaging (LGE-MRI) is associated with clinically significant SSS.…”

Robotic navigation for catheter ablation: benefits and challenges

“…While PV isolation remains the cornerstone of AF ablation, several studies have demonstrated that non-pulmonary vein foci also play an important role in initiation, maintenance and recurrence of AF [51-55]. Non-PV triggers are particularly important in patients with more longstanding AF, enlarged left atria and underlying heart disease, including HF [56]. Several studies have shown that ablation also of non-PV triggers, in addition to pulmonary vein isolation, improves arrhythmia free outcomes [57][58][59][60].…”