Arrhythmias & electrophysiologyCohort study
Ganglionated plexi ablation impact on atrial fibrillation (AF) mechanisms and outcomes in patients with low scar burden
- Prospective cohort study
Authors' conclusion
Ganglionated plexi ablation results in a mechanistic impact in AF with an ablation response, changes in DF, CS electrogram characteristics, and AF inducibility score. Pulmonary vein isolation and GP ablation in patients with minimal LVZs results in a high freedom from AF/AT.
Study context
- Population
- Patients undergoing persistent AF ablation with low scar burden (<30% low voltage zones (LVZs) in the left atrium)84 with <30% LVZs had ganglionated plexi (GP) ablation
- Participants
- 120 patients
- Exposure
- Pre- vs post-GP ablation
- Post-GP ablationn = 84
Main finding
As reported in the abstract
Mechanistic impact of GP ablation (pre- vs post-GP ablation)
- Ablation response in all patients: AF termination
- 66.7%
- Ablation response in all patients: CL slowing of ≥30 ms
- 33.3%
- Dominant frequency (DF), pre- vs post-GP ablation
- 6.3 ± 1.2 Hz vs. 5.1 ± 1.0 Hz; P < 0.001
- Coronary sinus (CS) cycle length variability (CLV), pre- vs post-GP ablation
- 40.2 ± 6.5 ms vs. 28.2 ± 6.8%; P < 0.001
- CS activation pattern stability (APS), pre- vs post-GP ablation
- 25.2 ± 5.8% vs. 35.2 ± 6.5%; P < 0.001
- AF inducibility score, pre- vs post-ablation (AF harder to induce post-GP ablation)
- 3.8 ± 1.2 vs. 1.3 ± 1.8; P < 0.001
Observational data: associations, not effects.
Further findings
Freedom from AF/AF/atrial tachycardia (AT) off anti-arrhythmic drugs (PVI + GP ablation, <30% LVZs) · 12 months
- Free from AF/AT off anti-arrhythmic drugs, of 84
- 78 (92.9%)
Original publication
Ganglionated plexi ablation impact on AF mechanisms and outcomes in patients with low scar burden. Europace. Published 25 August 2025. doi:10.1093/europace/euaf178
Summarised from the published abstract; every number is checked against it