Abstract 19741: Role of Ganglionated Plexus for the Maintenance of Atrial Fibrillation: Analysis of the Effect of Ganglionated Plexus Stimulation on the Atrial Activation Sequence

Background: It has been suggested that ganglionated plexus (GP) have a role to play in the initiation and maintenance of atrial fibrillation (AF) and is associated with the complex fractionated atrial electrogram (CFE) region. However, little is known about the effect of GP stimulation on the atrial activation sequence. Objectives: The aim of this study was to elucidate the effect of the GP stimulation on the left atrial activation sequence and define its role for AF driving mechanism. Methods: Selective endocardial mapping (EnSite 3000) of the left superior pulmonary vein (LSPV) was performed in 12 AF patients (9 paroxysmal and 3 persistent AF) during AF. GP stimulation was performed by the trans-catheter high-frequency stimulation (HFS), applied to the ostium of the LSPV (roof to the ridge of LSPV) at a frequency of 20 Hz and an output amplitude of 20 V. The activation sequence, involving the frequency of pivoting, wave break and fusion, and the area of CFE before GP stimulation were compared with those...