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04-05-2024 | Atrial Fibrillation | ORIGINAL RESEARCH

Impact of residual induction number of non-pulmonary vein foci on the 2-year outcomes in patients with paroxysmal atrial fibrillation

Authors: Yasuyuki Egami, Masaru Abe, Mizuki Osuga, Hiroaki Nohara, Shodai Kawanami, Kohei Ukita, Akito Kawamura, Koji Yasumoto, Masaki Tsuda, Naotaka Okamoto, Yasuharu Matsunaga-Lee, Masamichi Yano, Masami Nishino

Published in: Journal of Interventional Cardiac Electrophysiology

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Abstract

Background

Residual non-pulmonary vein (PV) foci are significantly associated with atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). However, we previously reported among patients with non-PV foci induced only once, none experienced AF recurrence. Thus, we aimed to investigate the correlation between the residual induction number of non-PV foci and ablation outcome in paroxysmal AF patients.

Methods and results

We investigated 55 paroxysmal AF patients with residual non-PV foci after PVI and ablation of non-PV-foci. Study patients were classified into the residual one-time induction of non-PV foci (residual OTI-nPVF) group (n = 23) and residual repeatedly induced non-PV foci (residual RI-nPVF) group (n = 32). Furthermore, the residual RI-nPVF group was divided into the low inducibility group (n = 10) and high inducibility group (n = 22) according to the presence or absence of non-PV foci provoked by two sets of drug induction tests (non-PV foci inducibility). In addition, the latter was divided into the ablation group (n = 14) or observation group (n = 8). The 2-year AF recurrence‐free rate in the residual RI-nPVF group was significantly lower compared to the residual OTI-nPVF group (53% vs. 90%, p = 0.018). There was no significant difference of the 2-year AF recurrence‐free rates in the inducibility of non-PV foci (p = 0.913) and the presence or absence of ablation (p = 0.812) in the residual RI-nPVF group.

Conclusions

Among paroxysmal AF patients, the presence of residual RI-nPVF was associated with higher AF recurrence compared to residual OTI-nPVF. Furthermore, within residual RI-nPVF subgroup, non-PV foci inducibility or ablation of some residual RI-nPVF did not affect ablation outcome.

Graphical Abstract

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Metadata
Title
Impact of residual induction number of non-pulmonary vein foci on the 2-year outcomes in patients with paroxysmal atrial fibrillation
Authors
Yasuyuki Egami
Masaru Abe
Mizuki Osuga
Hiroaki Nohara
Shodai Kawanami
Kohei Ukita
Akito Kawamura
Koji Yasumoto
Masaki Tsuda
Naotaka Okamoto
Yasuharu Matsunaga-Lee
Masamichi Yano
Masami Nishino
Publication date
04-05-2024
Publisher
Springer US
Published in
Journal of Interventional Cardiac Electrophysiology
Print ISSN: 1383-875X
Electronic ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-024-01820-z
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