Discussion
This retrospective case series describes non-PV, non-BOX, and non-SVC
trigger sites provoked by ATP injection and demonstrates the
effectiveness of the GP-based approach. The main findings of this study
were:
The incidence of ATP-induced AF after PV/Box isolation and SVC isolation
was 1.2%.
ATP-provoked trigger foci were distributed in particular sites, which
overlapped with the distribution of GP.
Among these trigger foci, we proved the presence of GP by the vagal
response to HFS in CS and RA posterior wall in six and two patients. CS-
and RA-GP ablation suppressed the ATP-induced AF with a modest amount of
RF application.
HFS within CS had a risk of ventricular fibrillation induction.