Aims: To study the potential efficacy of ganglionated plexi (GP) ablation in the setting of longstanding persistent atrial fibrillation (AF).
Methods And Results: Anatomic ablation at the areas of GP in the left atrium was performed in 89 patients with symptomatic, drug-refractory, persistent AF (71 men, 56 +/- 7 years of age). In 29 patients, a second procedure by means of circumferential pulmonary vein (PV) isolation was performed, and 5 of them were subjected to a third circumferential ablation. At 16 +/- 7 months after the final ablation procedure, 53 (59.6%) of the 89 patients were in sinus rhythm in the absence of antiarrhythmic drug therapy, 5 (5.6%) patients had permanent AF, and 31 (34.8%) patients had paroxysmal AF. The long-term success rate for patients who underwent a single ablation procedure with only GP ablation was 38.2% over a follow-up of 24 +/- 3 months. Independent predictors of later arrhythmia recurrences were left atrial diameter [HR 1.039 (1.00-1.07), P = 0.028] and duration of AF prior to ablation [HR 1.116 (1.02-1.22), P = 0.008].
Conclusion: Ganglionated plexi ablation in chronic AF results in long-term maintenance of sinus rhythm in 38.2% of cases. Repeat procedures with circumferential isolation of all PV offer a success rate of 59.6% over a follow-up of 16 +/- 7 months.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/europace/euq014 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Cardiovascular Disease-Specific Responses to Autonomic Denervation.
JACC Clin Electrophysiol
January 2025
Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning, China. Electronic address:
Background: Calcium-mediated autonomic denervation has been shown to suppress postoperative atrial fibrillation (POAF) after coronary artery bypass grafting.
Objectives: This study sought to evaluate whether similar autonomic denervation can prevent POAF after mitral or aortic valve surgeries.
Methods: This research consisted of 2 single-center, randomized, double-blind, sham-controlled trials: CAP-AF2 (Calcium Autonomic Denervation Prevents Postoperative Atrial Fibrillation in Patients Undergoing Isolated Mitral Valve Surgery for Mitral Regurgitation) for mitral valve (MV) surgery and CAP-AF3 (Calcium Autonomic Denervation Prevents Postoperative Atrial Fibrillation in Patients Undergoing Isolated Aortic Valve Surgery) for aortic valve surgery.
Vagal response during radiofrequency catheter ablation initiated from right superior pulmonary vein: Incidence, risk factors, and clinical outcomes.
Int J Cardiol
December 2024
Central China Fuwai Hospital, Heart Center of Henan Provincial People's Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China. Electronic address:
Article Synopsis
- The study investigates the vagal response (VR) during pulmonary vein isolation (PVI) for atrial fibrillation (AF), focusing on the incidence, risk factors, and outcomes of VR when initiated from the right superior pulmonary vein (RSPV).
- A total of 702 AF patients were included, with 77 (11.0%) experiencing 81 episodes of VR, primarily in those with paroxysmal AF, and common VR symptoms included sinus arrest and bradycardia.
- Increased body mass index (BMI) and left ventricular ejection fraction (LVEF) were identified as independent risk factors for VR, but the presence of VR did not correlate with improved long-term outcomes in AF recurrence.
Targeted Ganglionated Plexi Ablation With Nanoformulated Calcium Suppresses Postoperative AF Via Vagosympatholytic and Anti-Inflammatory Effects.
JACC Clin Electrophysiol
November 2024
Electrophysiology Section, Division of Cardiology, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA; Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA. Electronic address:
Background: The mechanisms underlying postoperative atrial fibrillation (POAF) remain unclear.
Objectives: The aim of this study was to test the hypothesis that targeted chemical ganglionated plexi (GP) modulation of all major left atrial-pulmonary vein GP using novel nanoformulated calcium chloride (nCaCl) can reverse postoperative neuroelectrical remodeling by suppressing vagosympathetic nerve activity and the localized inflammatory process, both critical substrates of POAF.
Methods: In a novel canine model of POAF with serial thoracopericardiotomies, sympathetic nerve activity (SNA), vagal nerve activity (VNA) and GP nerve activity (GPNA) were recorded; spontaneous and in vivo AF vulnerability were assessed; and atrial and circulating inflammatory markers and norepinephrine (NE) were measured to determine the neuroelectrical remodeling that promotes POAF and its subsequent modulation with nCaCl GP treatment (n = 6) vs saline sham controls (n = 6).
Differential and synergistic effects of right and left atrial ganglionated plexi ablation in patients undergoing cardioneuroablation: results from the ELEGANCE multicenter study.
J Interv Card Electrophysiol
December 2024
Arrhythmia Department, Teknon Heart Institute, Teknon Medical Center, Barcelona, Spain.
Background: Cardioneuroablation (CNA) treats reflex syncope by ablating ganglionated plexi (GPs) either confined to the right (RA) or left atrium (LA), or accessible from both. We assessed whether GP ablation in one atrium affects parasympathetic modulation in the other and how ablation sequence (RA then LA, or vice-versa) impacts efficacy.
Methods: Two propensity-matched groups of patients with reflex syncope or functional bradycardia were analyzed.
Cardioneuroablation: A novel application for the treatment of severe mixed-pattern vasovagal syncope and orthostatic tachycardia without cardioinhibition-A case report.
HeartRhythm Case Rep
November 2024
Imperial College Healthcare NHS Trust, London, United Kingdom.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!