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Review
. 2018 Dec;7(4):273-281.
doi: 10.15420/aer.2018.50.3.

Catheter Ablation of Paroxysmal Atrial Fibrillation Originating from Non-pulmonary Vein Areas

Satoshi Higa  1 , Li-Wei Lo  2   3 , Shih-Ann Chen  2   3
Affiliations
Review

Catheter Ablation of Paroxysmal Atrial Fibrillation Originating from Non-pulmonary Vein Areas

Satoshi Higa et al. Arrhythm Electrophysiol Rev. 2018 Dec.

Abstract

Pulmonary veins (PVs) are a major source of ectopic beats that initiate AF. PV isolation from the left atrium is an effective therapy for the majority of paroxysmal AF. However, investigators have reported that ectopy originating from non-PV areas can also initiate AF. Patients with recurrent AF after persistent PV isolation highlight the need to identify non-PV ectopy. Furthermore, adding non-PV ablation after multiple AF ablation procedures leads to lower AF recurrence and a higher AF cure rate. These findings suggest that non-PV ectopy is important in both the initiation and recurrence of AF. This article summarises current knowledge about the electrophysiological characteristics of non-PV AF, suitable mapping and ablation strategies, and the safety and efficacy of catheter ablation of AF initiated by ectopic foci originating from non-PV areas.

Keywords: Atrial fibrillation; catheter ablation; non-pulmonary vein; trigger.

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Conflict of interest statement

Disclosure: The authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Stepwise Algorithm for the Localisation of Non-pulmonary Vein AF Initiators
Figure 2:
Figure 2:. Mapping of Non-pulmonary Vein Triggers
See this image and copyright information in PMC

References

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