Recurrence of Atrial Fibrillation in Pulmonary and Non-Pulmonary Vein Trigger Ablations
Description
Background: Pulmonary vein isolation (PVI) has become standard of care in maintaining sinus rhythm in paroxysmal atrial fibrillation (AF). However, the recurrence of arrhythmia post PVI alone in persistent AF remains high. We assessed if substrate-based ablation strategy improved outcomes.
Objective: To characterize the recurrence of atrial arrhythmia after PVI and non-PVI triggers ablation in persistent AF.
Methods: We evaluated the recurrence of atrial arrhythmia in patients who had undergone ablation between 2019-2021 for persistent atrial fibrillation. Patients were grouped based on PVI alone versus PVI along with non-PVI triggers ablation (cavotricuspid isthmus, posterior wall isolation, vein of marshal ethanol ablation, mitral isthmus or complex fragmented atrial electrogram ablation) based on the substrate (PVI plus arm) and the recurrence of atrial arrhythmia were assessed.
Results: Out of 156 patients who had undergone ablation for persistent AF, 57 had PVI alone and remaining 99 had PVI along with non-PVI triggers ablation (Fig. 1). Out of them, 14 (9%) had recurrence of atrial arrhythmias in 1 year, 5 (8.7%) in PVI alone arm and 9 (9.1%) in PVI plus arm. 5 had minor complications (fever, access site bleeding, urinary retention), 3 had complications that lead to increased hospitalization (pericardial effusion, heart failure or minor pulmonary hemorrhage) but no deaths.
Conclusion: In patients with persistent AF, targeting PVI along with substrate-based ablation seem to have better outcome without significant difference in complications.
Citation Information
Rizvi, Madeeha; Kattel, Sharma; Murthy, Smitha; Sharma, Yatharth; Zhi, Emily; Rizvi, Zaid; and Tholakanahalli, Venkat N., "Recurrence of Atrial Fibrillation in Pulmonary and Non-Pulmonary Vein Trigger Ablations" (2026). Office of Research DMU Research Symposium. 34.
https://digitalcommons.dmu.edu/researchsymposium/2025rs/2025abstracts/34
Recurrence of Atrial Fibrillation in Pulmonary and Non-Pulmonary Vein Trigger Ablations
Background: Pulmonary vein isolation (PVI) has become standard of care in maintaining sinus rhythm in paroxysmal atrial fibrillation (AF). However, the recurrence of arrhythmia post PVI alone in persistent AF remains high. We assessed if substrate-based ablation strategy improved outcomes.
Objective: To characterize the recurrence of atrial arrhythmia after PVI and non-PVI triggers ablation in persistent AF.
Methods: We evaluated the recurrence of atrial arrhythmia in patients who had undergone ablation between 2019-2021 for persistent atrial fibrillation. Patients were grouped based on PVI alone versus PVI along with non-PVI triggers ablation (cavotricuspid isthmus, posterior wall isolation, vein of marshal ethanol ablation, mitral isthmus or complex fragmented atrial electrogram ablation) based on the substrate (PVI plus arm) and the recurrence of atrial arrhythmia were assessed.
Results: Out of 156 patients who had undergone ablation for persistent AF, 57 had PVI alone and remaining 99 had PVI along with non-PVI triggers ablation (Fig. 1). Out of them, 14 (9%) had recurrence of atrial arrhythmias in 1 year, 5 (8.7%) in PVI alone arm and 9 (9.1%) in PVI plus arm. 5 had minor complications (fever, access site bleeding, urinary retention), 3 had complications that lead to increased hospitalization (pericardial effusion, heart failure or minor pulmonary hemorrhage) but no deaths.
Conclusion: In patients with persistent AF, targeting PVI along with substrate-based ablation seem to have better outcome without significant difference in complications.
