Non-pulmonary vein triggers in nonparoxysmal atrial fibrillation: Implications of pathophysiology for catheter ablation

Domenico G. Della Rocca; Nicola Tarantino; Chintan Trivedi; Sanghamitra Mohanty; Alisara Anannab; Anu S. Salwan; Carola Gianni; Mohamed Bassiouny; Amin Al-Ahmad; Jorge Romero; David F. Briceño; J. David Burkhardt; G. Joseph Gallinghouse; Rodney P. Horton; Luigi Di Biase; Andrea Natale

doi:10.1111/jce.14638

Non-pulmonary vein triggers in nonparoxysmal atrial fibrillation: Implications of pathophysiology for catheter ablation

Domenico G. Della Rocca, Nicola Tarantino, Chintan Trivedi, Sanghamitra Mohanty, Alisara Anannab, Anu S. Salwan, Carola Gianni, Mohamed Bassiouny, Amin Al-Ahmad, Jorge Romero, David F. Briceño, J. David Burkhardt, G. Joseph Gallinghouse, Rodney P. Horton, Luigi Di Biase, Andrea Natale

Medicine

Research output: Contribution to journal › Review article › peer-review

43 Scopus citations

Abstract

Rhythm control of persistent atrial fibrillation (AF) patients represents a challenge for the modern interventional cardiac electrophysiologist; as a matter of fact, there is still divergence regarding the best ablative approach to adopt in this population. Different investigational endpoints, variability of techniques and tools, significant technological evolution, and the lack of universally accepted pathophysiological models engendered a considerable heterogeneity in terms of techniques and outcomes, so much that the treatment of persistent subtypes of AF commonly still relies mainly on pulmonary vein (PV) isolation. The purpose of the present review is to report the current experimental and clinical evidence supporting the importance of mapping and ablating non-PV triggers and describe our institutional approach for the ablation of nonparoxysmal AF.

Original language	English (US)
Pages (from-to)	2154-2167
Number of pages	14
Journal	Journal of cardiovascular electrophysiology
Volume	31
Issue number	8
DOIs	https://doi.org/10.1111/jce.14638
State	Published - Aug 1 2020

Keywords

atrial fibrillation
catheter ablation
coronary sinus
crista terminalis
interatrial septum
left atrial appendage
mapping
outcomes
pathophysiology
pulmonary vein
superior vena cava
trigger

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Physiology (medical)

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10.1111/jce.14638

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Della Rocca, D. G., Tarantino, N., Trivedi, C., Mohanty, S., Anannab, A., Salwan, A. S., Gianni, C., Bassiouny, M., Al-Ahmad, A., Romero, J., Briceño, D. F., Burkhardt, J. D., Gallinghouse, G. J., Horton, R. P., Di Biase, L., & Natale, A. (2020). Non-pulmonary vein triggers in nonparoxysmal atrial fibrillation: Implications of pathophysiology for catheter ablation. Journal of cardiovascular electrophysiology, 31(8), 2154-2167. https://doi.org/10.1111/jce.14638

Della Rocca, DG, Tarantino, N, Trivedi, C, Mohanty, S, Anannab, A, Salwan, AS, Gianni, C, Bassiouny, M, Al-Ahmad, A, Romero, J, Briceño, DF, Burkhardt, JD, Gallinghouse, GJ, Horton, RP, Di Biase, L & Natale, A 2020, 'Non-pulmonary vein triggers in nonparoxysmal atrial fibrillation: Implications of pathophysiology for catheter ablation', Journal of cardiovascular electrophysiology, vol. 31, no. 8, pp. 2154-2167. https://doi.org/10.1111/jce.14638

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abstract = "Rhythm control of persistent atrial fibrillation (AF) patients represents a challenge for the modern interventional cardiac electrophysiologist; as a matter of fact, there is still divergence regarding the best ablative approach to adopt in this population. Different investigational endpoints, variability of techniques and tools, significant technological evolution, and the lack of universally accepted pathophysiological models engendered a considerable heterogeneity in terms of techniques and outcomes, so much that the treatment of persistent subtypes of AF commonly still relies mainly on pulmonary vein (PV) isolation. The purpose of the present review is to report the current experimental and clinical evidence supporting the importance of mapping and ablating non-PV triggers and describe our institutional approach for the ablation of nonparoxysmal AF.",

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AU - Mohanty, Sanghamitra

AU - Anannab, Alisara

AU - Salwan, Anu S.

AU - Gianni, Carola

AU - Bassiouny, Mohamed

AU - Al-Ahmad, Amin

AU - Romero, Jorge

AU - Briceño, David F.

AU - Burkhardt, J. David

AU - Gallinghouse, G. Joseph

AU - Horton, Rodney P.

AU - Di Biase, Luigi

AU - Natale, Andrea

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AB - Rhythm control of persistent atrial fibrillation (AF) patients represents a challenge for the modern interventional cardiac electrophysiologist; as a matter of fact, there is still divergence regarding the best ablative approach to adopt in this population. Different investigational endpoints, variability of techniques and tools, significant technological evolution, and the lack of universally accepted pathophysiological models engendered a considerable heterogeneity in terms of techniques and outcomes, so much that the treatment of persistent subtypes of AF commonly still relies mainly on pulmonary vein (PV) isolation. The purpose of the present review is to report the current experimental and clinical evidence supporting the importance of mapping and ablating non-PV triggers and describe our institutional approach for the ablation of nonparoxysmal AF.

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Non-pulmonary vein triggers in nonparoxysmal atrial fibrillation: Implications of pathophysiology for catheter ablation

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