Arrhythmias & electrophysiology
Premature Ventricular Complexes After Atrial Fibrillation Ablation
- retrospective, single-center cohort study
- acetylcholinesterase staining in human hearts
+1 more
- acetylcholinesterase staining in human hearts
Authors' conclusion
EAS-VOMEI was associated with a higher occurrence of PVCs, which more commonly originated from the papillary muscles. EAS-VOMEI may affect ventricular innervation. Future studies are warranted to investigate the ventricular neuromodulatory impact of VOMEI.
Study context
- Population
- Patients after AF ablation with and without EAS with VOMEI (EAS-VOMEI)251 each · EAS-VOMEI 251 · without EAS-VOMEI 251
- Participants
- 502 patients
- Exposure
- AF ablation with vs without EAS-VOMEI
- EAS-VOMEIn = 251
- without EAS-VOMEIn = 251
Main finding
As reported in the abstract
PVC incidence
EAS-VOMEI
70 of 251
events
without EAS-VOMEI
15 of 251
events
VOMEIAdjusted hazard ratio (95% CI)P value
time-to-event analysis over 12 months
4.6(1.5–13.7)
P = 0.005- higher odds of PVC incidence
- odds (Firth penalized logistic regression) 5.2 (95% CI 2.4–12.1); P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | EAS-VOMEI | without EAS-VOMEI |
|---|---|---|
| Papillary muscle PVCs (among patients with PVCs) | 47 of 70 events | 5 of 15 events |
| Bigeminy (among patients with PVCs) | 24 of 70 events | 3 of 15 events |
| Multifocal PVCs (among patients with PVCs) | 33 of 70 events | 6 of 15 events |
| PVC ablation required | 20 events | 7 events |
- Papillary muscle premature ventricular complexes (PVCs) (among patients with PVCs): P < 0.001
- Bigeminy (among patients with PVCs): P < 0.001
- Multifocal PVCs (among patients with PVCs): P < 0.001
- PVC ablation required: P = 0.01
PVC ablation required
- PVC ablation was required in 20 of 70 post-EAS-VOMEI vs 7 of 15 without EAS-VOMEI (P = 0.01)
Innervation (acetylcholinesterase staining)
- Innervation around the vein of Marshall and coronary sinus reached the basal left ventricle
Original publication
Premature Ventricular Complexes After Atrial Fibrillation Ablation. JACC Clin Electrophysiol. Published 24 March 2026. doi:10.1016/j.jacep.2026.02.003
Summarised from the published abstract; every number is checked against it