Evidence map›Paper›PMID 40974035›Full record

Observational studyEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2025

Mapping and ablation outcomes of extra-pulmonary vein triggers in atrial fibrillation: single-centre retrospective study with consistent provocation protocol.

Seunghoon Cho, Daehoon Kim, Hanjin Park, Oh-Seok Kwon, Hee Tae Yu, Tae-Hoon Kim, Jae-Sun Uhm, Boyoung Joung, Moon-Hyoung Lee, Hui-Nam Pak

Registry-linked trialAbstract readObservational Study
In one paragraph

Observational study in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02138695 (The Evaluation for Prognostic Factors After Catheter Ablation of Atrial Fibrillation), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02138695 recruitingnot on this map

The Evaluation for Prognostic Factors After Catheter Ablation of Atrial Fibrillation: Cohort Study

TypeobservationalSponsorYonsei UniversityRan2014 to 2029Enrolled3,100ConditionsAtrial Fibrillation
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Catheter ablation of atrial fibrillation in transthyretin and light-chain cardiac amyloidosis: results from the multicentre AMYL-AF study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Observational
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Seunghoon ChoDivision of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.ORCID 0009-0008-1276-0556
Daehoon KimDivision of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.ORCID 0000-0002-9736-450X
Hanjin ParkDivision of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
Oh-Seok KwonDivision of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.ORCID 0000-0002-8465-5412
Hee Tae YuDivision of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.ORCID 0000-0002-6835-4759
Tae-Hoon KimDivision of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.ORCID 0000-0003-4200-3456
Jae-Sun UhmDivision of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.ORCID 0000-0002-1611-8172
Boyoung JoungDivision of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.ORCID 0000-0001-9036-7225
Moon-Hyoung LeeDivision of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.ORCID 0000-0002-7268-0741
Hui-Nam PakDivision of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.ORCID 0000-0002-3256-3620

Funding

Korea governmentKorea Medical Device Development Fund 1711174471Korea Medical Device Development Fund RS-2022-00141473Korean Cardiac Research Foundation 202303-01Korean Heart Rhythm Society KHRS2023-2
6 · The paper itself

Abstract

aimsExtra-pulmonary vein triggers (ExPVTs) are recognized as important contributors to atrial fibrillation (AF) recurrence after radio-frequency catheter ablation (RFCA). This study aimed to investigate the clinical characteristics, diagnostic value, and prognostic implications of isoproterenol-induced ExPVTs in patients undergoing de novo RFCA with circumferential pulmonary vein isolation (CPVI). METHODS AND

resultsWe analysed 2619 non-valvular AF patients (25.8% female, mean age 59.4 ± 10.9 years, 60.7% with paroxysmal AF) who underwent CPVI and standardized isoproterenol provocation testing; 98.2% also received empirical right atrial (RA) ablation. We evaluated the clinical and prognostic significance of ExPVTs for AF recurrence within 2 years, considering their anatomical location and targeted ablation status. ExPVTs were identified in 13.5% of patients. Lower mean left atrial (LA) voltage was independently associated with ExPVTs, irrespective of sex. Importantly, ExPVTs remained independently associated with AF recurrence [hazard ratio (HR) 1.81 (95% confidence interval 1.39-2.35)], alongside AF type, body mass index, LA volume index, and mean LA voltage as significant predictors. LA [HR 1.50 (1.04-2.17)] and septal [HR 1.51 (1.02-2.23)] triggers were significantly associated with recurrence, while RA triggers were not, given the high rate of empirical RA ablation (98.9%). Recurrence risk was highest in patients with multiple or unmappable triggers and in those without ExPVT-targeted ablation.

conclusionExPVTs are strongly associated with lower LA voltage and carry independent prognostic value for AF recurrence, with outcomes varying by anatomical location and targeted ablation status. These findings underscore the importance of systematic ExPVT assessment and selective targeting in individualized ablation strategies. CLINICAL

trial registrationNCT02138695.

Indexed as

Atrial FibrillationCatheter AblationElectrophysiologic Techniques, CardiacPulmonary VeinsAction PotentialsAgedFemaleHumansIsoproterenolMaleMiddle AgedPredictive Value of TestsRecurrenceRetrospective StudiesRisk FactorsTime FactorsIsoproterenolAtrial fibrillationCatheter ablationExtrapulmonary vein triggersPrognostic value

Identifiers

PMID40974035
PMCPMC12510313

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.