Exploration of Theoretical Ganglionated Plexi Ablation Technique in Atrial Fibrillation Surgery

JCS/JHRS 2019 guideline on non‐pharmacotherapy of cardiac arrhythmias

“…In recent years, ganglionated plexus (GP) ablation has been performed as part of AF surgery 1311‐1313 . A meta‐analysis found that the addition of GP ablation to the maze procedure or PVI resulted in better short‐ and mid‐term outcomes than either surgery alone 1314 .…”

Total endoscopic ablation of patients with long-standing persistent atrial fibrillation: a randomized controlled study

“…Therefore, studies of hybrid procedures have been initiated and show promising results [20], but are still questioned in relation to results for the Cox maze procedure [21]. In the light of the results from the present study, we speculate that the lesion also involves a partial denervation of ganglionic plexi, which are distributed in some of the areas where the ablation probe is placed [22].…”

Ganglionated Plexi Ablation for the Treatment of Atrial Fibrillation

“…Most patients involved in GP ablation procedures experience paroxysmal, persistent or long-standing persistent AF with some studies comparing all three [ 116 ]. Patients with symptomatic AF or AF associated with valvular disease are also included in research studies [ 95 , 144 ]. Similarly, investigations into specific AF types are not consistent, which leads to difficulty in assessing the extent to which GP ablation is effective.…”

“…In support of this, there was significantly higher AF and atrial tachyarrhythmia (AT) recurrence rates reported in patients who underwent selective GP ablation of the right side first [ 93 ]. This study also implied that ablation of one active GP out of sequential pacing is insufficient for vagal denervation [ 95 ]. It is worth noting that no significant difference was observed between patients who underwent extensive anatomical mapping instead of HFS [ 93 ].…”