Arrhythmias & electrophysiology
Incremental Benefit of Stepwise Nonpulmonary Vein Trigger Provocation During Catheter Ablation of Atrial Fibrillation
Authors' conclusion
The majority of non-PV triggers require provocative maneuvers for induction. A stepwise provocation protocol consisting of isoproterenol infusion followed by burst pacing identifies a 3.6-fold higher number of patients with non-PV triggers.
Study context
- Population
- Consecutive patients undergoing first-time atrial fibrillation (AF) ablation, 2020–2022
- Participants
- 1,372 patients
- Exposure
- Stepwise provocation protocol for non-PV triggers
- Complete stepwise protocoln = 883
- Isoproterenol onlyn = 334
- Burst pacing onlyn = 77
- No provocationn = 78reference
- Outcome
- Non-PV triggers (non-PV ectopic beats triggering AF or sustained focal atrial tachycardia)
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Non-PV triggers
- Non-PV triggers found (overall)
- 161
- Patients with non-PV triggers
- 135 (9.8%)
- Spontaneous non-PV triggers
- 51 (31.7%)
- Non-PV triggers requiring provocative maneuvers
- 110 (68.3%)
- Complete protocol: increase in patients with non-PV triggers after isoproterenol
- 2.2-fold
- Complete protocol: total increase with isoproterenol plus burst pacing
- 3.6-fold
Observational data: associations, not effects.
Original publication
Incremental Benefit of Stepwise Nonpulmonary Vein Trigger Provocation During Catheter Ablation of Atrial Fibrillation. JACC Clin Electrophysiol. Published July 2024. doi:10.
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