Arrhythmias & electrophysiologyCohort study
Embryological Classification of Arrhythmogenic Triggers Initiating Atrial Fibrillation
- Cohort study
- genetic analysis subcohort
Authors' conclusion
SV-derived AF triggers may have hereditary factors with a favorable postablation prognosis, whereas PA-derived triggers are linked to AF persistence and poor ablation response.
Study context
- Population
- Patients with atrial fibrillation (AF) undergoing pulmonary vein (PV) isolation815 with genetic analysis
- Participants
- 3,067 patients
- Exposure
- Common PV vs sinus venosus (SV) vs primitive atrium (PA)
- SVn = 622
- PAn = 365
Main finding
As reported in the abstract
Arrhythmia recurrence after repeated procedures
Hazard ratio (95% CI)P value
PA vs Common PV
1.75(1.34–2.29)
P < 0.001PA vs SV
1.31(1.19–1.45)
P < 0.001Observational data: associations, not effects.
Further findings
| Outcome | Common PV | SV | PA |
|---|---|---|---|
| Prevalence of extra-PV AF trigger origin (cohort 1) | Not reported in the abstract | 20.3% | 11.9% |
Predictors of trigger origin (multivariate, cohort 2)
- SV-AF associated with female sex, lower BMI, absence of hypertension, rs2634073 near PITX2 and rs6584555 in NEURL1
- PA-AF predicted by nonparoxysmal AF and rs2634073 near PITX2
Safety
Adverse events
- Incidence did not differ significantly among the 3 groups
Original publication
Embryological Classification of Arrhythmogenic Triggers Initiating Atrial Fibrillation. J Am Coll Cardiol. Published 23 October 2024. doi:10.1016/j.jacc.2024.08.060
Summarised from the published abstract; every number is checked against it