Arrhythmias & electrophysiology
Role of Non–Pulmonary Vein Triggers in Outcomes of First-Time Atrial Fibrillation Ablation
Authors' conclusion
Failure to ablate induced NPV triggers is associated with a high risk of recurrence. Although the ablation of NPV triggers reduces recurrence rates to levels approaching those without such triggers, their presence indicates a modestly worse prognosis.
Study context
- Population
- Patients undergoing first-time AF ablation using radiofrequency energy between 2018 and 2023 who received trigger provocative maneuverspatients included
- Participants
- 2,315 patients
- Comparison
- Outcome of patients undergoing AF ablation based on their NPV trigger status
- Without NPV triggersn = 2,046reference
- Ablated NPV triggersn = 233
- Untreated NPV triggersn = 36
- Outcome
- Recurrence (AF/AT >30 seconds after a 90-day blanking period)
- Follow-up
- One-year
Main finding
As reported in the abstract
Each group vs without NPV triggersAdjusted hazard ratio (95% CI)
Ablated NPV triggers
1.35(1.08–1.69)
Untreated NPV triggers
3.71(2.48–5.54)
Further findings
Recurrence by NPV trigger subtype and provocation method
- This response pattern remained consistent regardless of NPV trigger subtype (AF vs focal atrial tachycardia (AT)) or provocation method (spontaneous vs induced triggers)
Original publication
Role of Non–Pulmonary Vein Triggers in Outcomes of First-Time Atrial Fibrillation Ablation. JACC Clin Electrophysiol. Published 26 February 2026. doi:10.
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