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Atrial Fibrillation Triggers Originate in Pulmonary Veins

Often originate from the carina zone

TUESDAY, Oct. 14 (HealthDay News) -- Triggers of atrial fibrillation often originate from the carina zone of the pulmonary veins, according to study findings published in the Oct. 21 issue of the Journal of the American College of Cardiology.

Ermengol Valles, M.D., and colleagues from the University of Pennsylvania School of Medicine in Philadelphia identified the origin within the pulmonary vein of triggers of atrial fibrillation (spontaneous and provoked) in 45 patients with the condition using multipolar catheter recordings.

The researchers observed 63 reproducible triggers in 82 percent of patients, of which 57 (90 percent) originated from the pulmonary vein. Of those originating from the pulmonary vein, 63 percent originated from the carina zone segments (seven segments between the pulmonary veins), nearly equally divided between the left and right pulmonary veins, the investigators found. Compared with non-carina zone triggers, the carina zone triggers were spontaneous or elicited with cardioversion significantly more often. In contrast, non-carina zone triggers were significantly more likely to require elicitation with isoproterenol, the report indicates.

"Reproducible spontaneous and provoked pulmonary vein triggers initiating atrial fibrillation can be observed in most patients undergoing atrial fibrillation ablation," Valles and colleagues conclude. "These triggers most commonly originate from the carina region of both right and left pulmonary veins."

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