Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-136 - Characteristics And Ablation Outcome Of NondashPulmonary Vein Ectopy Emerging After Successful Pulmonary Vein Isolation In Patients With Paroxysmal Atrial Fibrillation (ID 1118)


Background: Non-pulmonary vein (PV) ectopy emerges during catheter ablation even after successful pulmonary vein isolation (PVI) in patients with paroxysmal atrial fibrillation (PAF). The influence of non-PV ectopy on ablation outcome remains uncertain.
Objective: The aim of the study is to elucidate the characteristics and ablation outcome of non-PV ectopy emerging after successful PVI in patients with PAF.
Methods: From 2016 to 2019, 638 consecutive patients who underwent CA for PAF were enrolled in the study. After PVI, non-PV ectopy was recorded spontaneously or administration of adenosine (ATP) and/or isoproterenol (ISP). The number, origin of non-PV ectopy and ablation outcome were analyzed.
Results: Among 638 patients who underwent CA of PAF, 68 patients (44 men, age 63±12 years, 39 1st session) revealed 77 non-PV ectopies after successful PVI during the ablation. The origin of ectopies were superior vena cava (SVC)(n=36, 47%), right atrium (RA)(n=19, 25%), left atrial appendage (n=6, 8%), coronary sinus (n=6, 8%) and others (n=10, 12%). Non-PV ectopies were documented spontaneously(n=45) and after administration of ATP and/or ISP (ATP/ISP group) (n=32). Compared these two groups, Non-PV ectopies from RA were more often seen in ATP/ISP group (8% vs. 46% P<0.01). Among the 68 patients (1st session n=39, 2nd session n=22. 3rd session n=7), acute success of eliminating non-PV ectopy was achieved in 47 patients and remaining 21 patients had residual ectopy. During 14±10 months of follow-up, there was no difference in arrhythmia recurrence rate between patients with or without residual ectopy (24% vs. 17% Log-rank p = 0.68). Among the 39 patients with first session, non-PV ectopy was eliminated in 24 patients and remaining 15 patients had residual ectopy. The arrhythmia free rate was similar between patients with or without residual ectopy (73% vs. 75% Log-rank p = 0.98).
Conclusion: Most of the non-PV ectopy after successful PVI emerged from SVC and RA. Right atrium originated ectopies were more often observed by ATP/ISP administration. The elimination of non-PV ectopy may not improve ablation outcome in patients with PAF.