PO-01-037 RISK FACTORS FOR PRESENCE OF NON-PULMONARY VEIN TRIGGERS FOR ATRIAL FIBRILLATION

Targeting of non-pulmonary vein triggers (NPVTs) after pulmonary isolation (PVI) may reduce atrial fibrillation (AF) recurrence. Incrementally dosed isoproterenol infusion (up to 30mcg/min) and cardioversion induced AF used provoke NPVTs typically requires additional vasopressor support increases procedure time. We aimed identify risk factors for the presence in order patient profiles which NPVT provocation would have greatest yield. Using Hospital University Pennsylvania ablation registry, we compared patients whom were observed not using a standard protocol. defined as single or sequence ectopic beats triggering non-sustained sustained focal tachycardia. Continuous variables unpaired t-Test categorical Fisher exact test. In total 1,306 between January 2021 August 2022, 87% underwent testing 10% all had observed. Compared those without NPVTs, who more likely be female (41% vs 30%, OR 1.62 [1.12-2.35], p=0.01), sinus node dysfunction (17% 7%, 2.83 [1.72-4.65], p=0.0002), prior (68% 34%, 4.16 [2.82-6.19], p=<0.0001), left scar (>2cm2) (71% 36%, 4.28 [2.78-6.53], p=<0.0001) identified during voltage mapping (defined peak bipolar <0.5mV at least three abnormal contiguous electrograms outside veins, Table 1). this cohort, absence these four yielded rate 0.02%, while led 30-50% (Figure Incremental associated allows prediction likelihood that will lead induction influence decision making undertake ablation.Tabled 1Table 1VariableOverall (N=1306)NPVT (N=130)No (N=1006)P ValueOdds Ratio (95% CI)Age (years)130665.89 ± 9.9965.00 10.590.36BMI130629.16 5.6229.95 6.270.17LVEF (%)126656.42 9.5755.28 11.210.27LA volume index (mL/m2)62639.34 17.8939.25 17.180.97CHA2DS2VASc score13002.40 1.452.41 1.560.94Female40353 (41)350 (30)0.011.62 (1.12-2.35)Hx CVA/TIA12314 (11)109 (9)0.53Diabetes20215 (12)187 (16)0.25Heart Failure / CM41738 (29)379 (32)0.55Hypertension1031105 (81)926 (79)0.65Obstructive Sleep Apnea42343 (33)380 (32)0.84Sinus Node Dysfunction10122 (17)79 (7)0.00022.83 (1.72-4.65)Non-Paroxysmal AF478/124151 (41)427 (38)0.63Had Previous Ablation48288 (68)394 (34)<0.00014.16 (2.82-6.19)Has LA (Any LVA)426/106978 (71)348 (36)<0.00014.28 (2.78-6.53)Values are reported mean SD, number (%). P value is comparing group No group. t-Test, BMI=body mass index; LVEF=left ventricular ejection fraction; LA=left atrium; CVA=cerebrovascular accident; TIA=transient ischemic attack, CM=cardiomyopathy; AF=atrial fibrillation; LVA=low area; NPVT=non-pulmonary trigger Open table new tab