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In the GANGLIA-AF study, published in Heart Rhythm, researchers hypothesized that ablating the ectopy&ndash;triggering ganglionated plexuses (ET-GP) of the intrinsic cardiac autonomic system may serve to reduce the incidence of atrial fibrillation (AF). The study&rsquo;s lead author, Min-Young Kim, and colleagues found that GP ablation (GPA) without pulmonary vein isolation (PVI) did not reduce atrial arrhythmias more than PVI in patients with paroxysmal AF.A total of 102 patients were enrolled into the randomized trial after receiving GPA or PVI and followed for 12 months, including 48-hour Holter monitors every three months. ET-GPs were mapped using high-frequency stimulation (HFS) during the atrial refractory period and ablated until they no longer function. As a follow&ndash;up, if cases of triggered AF became persistent, atrioventricular disassociating GPs (AVD-GP) were also ablated. The primary endpoint was documented &ge;30 second atrial arrhythmia after a three-month blanking period.&nbsp;Fifty-two patients underwent GPA and 50 underwent PVI. GPA patients had 89&plusmn;26 HFS sites tested, identifying a median of 18.5 GPs (interquartile range [IQR], 16&ndash;21%). RF ablation procedure time for GPA patients was 22.9 &plusmn; 9.8mins versus 38 &plusmn; 14.4mins in PVI (p &lt; 0.0001). GPA participants&rsquo; freedom from &ge;30 second atrial arrhythmias at 12-month follow-up was 50%, comparted to 64% with PVI (log rank p = 0.09). ET-GP ablation without AVD-GP ablation achieved 58% (n = 22/38) freedom from the primary endpoint. There was a significantly higher reduction in AAD usage post-ablation after GPA versus PVI (55.5% vs. 36%; p = 0.05). Patients were referred for redo ablations in 31% (n = 16/52) after GPA and 24% (n = 12/50) after PVI (p = 0.53).While the two techniques did not produce different results in terms of preventing arrhythmias, the authors did note that, &ldquo;less RF ablation was delivered to achieve a higher reduction in anti-arrhythmic drug usage with GPA than PVI.&rdquo;

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GANGLIA-AF: Ectopy-Triggering Ganglionated Plexus Ablation to Prevent Atrial Fibrillation

Atrial Fibrillation

In the GANGLIA-AF study, published in Heart Rhythm, researchers hypothesized that ablating the ectopy–triggering ganglionated plexuses (ET-GP) of the intrinsic cardiac ...

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