Arrhythmias & electrophysiology
Mapping and ablation outcomes of extra-pulmonary vein triggers in atrial fibrillation: single-centre retrospective study with consistent provocation protocol
Main finding · AF recurrenceResult — go to the resultHazard ratio 1.81 95% CI 1.39–2.35Authors' conclusion
ExPVTs are strongly associated with lower LA voltage and carry independent prognostic value for AF recurrence, with outcomes varying by anatomical location and targeted ablation status.
Study context
- Population
- Non-valvular atrial fibrillation (AF) patients undergoing de novo radio-frequency catheter ablation (RFCA) with circumferential pulmonary vein isolation (CPVI) and isoproterenol provocation testing
- Participants
- 2,619 patients
- Exposure
- Extra-pulmonary vein triggers (ExPVTs) vs no ExPVTs
- Outcome
- AF recurrence
- Follow-up
- Within 2 years
Methodological detailssingle-centre, standardized isoproterenol provocation protocol
- Single-centre
- Standardized isoproterenol provocation protocol
Main finding
As reported in the abstract
Hazard ratio
1.81
95% CI 1.39–2.35
ExPVTsvs No ExPVTs
HR 1.81 (95% CI 1.39–2.35)
- ExPVTs identified
- 13.5%
Observational data: associations, not effects.
Further findings
AF recurrence by trigger location
| HR (CI) | ||
|---|---|---|
| LA triggers | 1.50 (1.04–2.17) | |
| Septal triggers | 1.51 (1.02–2.23) | |
| 0.512Hazard ratio (log scale) |
- Right atrial (RA) triggers not significantly associated with recurrence (empirical RA ablation rate 98.9%)
Recurrence by trigger number and targeted ablation
- Recurrence risk highest with multiple or unmappable triggers and without ExPVT-targeted ablation
Predictors of ExPVTs
- Lower mean left atrial (LA) voltage independently associated with ExPVTs, irrespective of sex
Original publication
Mapping and ablation outcomes of extra-pulmonary vein triggers in atrial fibrillation: single-centre retrospective study with consistent provocation protocol. Europace. Published 20 September 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →