Ablation of Nonpulmonary Vein Triggers

Young Hoon Kim, Doni Friadi, Suk Kyu Oh, Yun Gi Kim, Kwang No Lee, Hee Soon Park, Jaemin Shim, Jong Il Choi

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Nonpulmonary vein (non-PV) “triggers” can be identified in 10% to 33% of unselected patients with atrial fibrillation (AF). Compared with paroxysmal AF, the incidence of non-PV foci is higher in patients with persistent AF. Ablation of non-PV triggers is also important for patients with persistent AF and for those patients who undergo repeat ablation procedures in whom all PVs are found to be isolated. Accurate mapping/localization of non-PV triggers is a prime step and can be achieved with a systematic approach based on the analysis of the P wave morphology, intraatrial activation patterns at multipolar catheters in the standardized position of both atria, and the earliest activation site with direct recording. Ablation should be targeted at a specific site of origin or isolation of certain non-PV structures including superior vena cava, coronary sinus, posterior wall of the left atrium, and left atrial appendage.

Original languageEnglish
Title of host publicationCatheter Ablation of Cardiac Arrhythmias
PublisherElsevier
Pages244-256.e2
ISBN (Electronic)9780323529921
DOIs
Publication statusPublished - 2019 Jan 1

Bibliographical note

Publisher Copyright:
© 2019 Elsevier Inc. All rights reserved.

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Electrode mapping
  • Nonpulmonary vein trigger
  • Superior vena cava

ASJC Scopus subject areas

  • General Medicine

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