Additional Ganglion Plexus Ablation During Thoracoscopic Surgical Ablation of Advanced Atrial Fibrillation

Berger, Wouter R.; Neefs, Jolien; Berg, Nicoline W. E. van den; Krul, Sébastien P.J.; Praag, E. M. van; Piersma, Femke R.; Jong, Jonas S.S.G. de; Gründeman, Paul F.; Driessen, Antoine H.G.; Groot, Joris R. de

doi:10.1016/j.jacep.2018.10.008

Cited by 26 publications

(22 citation statements)

References 24 publications

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“…GP ablation has been strongly proved to be beneficial for postoperative sinus rhythm maintenance by many catheter‐based RCTs and previous meta‐analysis . On the other hand, the AFACT study, which is the only RCT focusing on surgical ablation of AF, finally comes to a 2 years follow‐up . The large sample‐sized study was carried out by an experienced surgical center and GP ablation was guided by both anatomic and high‐frequency stimulation (HFS).…”

Section: Discussionmentioning

confidence: 99%

“…Ganglion plexus (GP), embedded in epicardial fat pads on the surface of atria and ventricles, is a major component of cardiac ANS . GP ablation has been introduced as a target in addition to PVI for AF treatment by a number of clinical trials . But the results on the beneficial effect of adjunctive GP ablation were conflicting among different techniques.…”

Section: Introductionmentioning

confidence: 99%

“…[11][12][13][14] But the results on the beneficial effect of adjunctive GP ablation were conflicting among different techniques. A randomized controlled trial (AFACT) 14 based on thoracoscopic AF surgery showed no reduction on AF recurrence during the 2-year follow-up, whereas other clinical trials based on CA presented a significant improvement of the outcome. [11][12][13] The existing meta-analysis consisted of or dominated by studies based on CA and they failed to bring up a deep discussion on its different effects between CA and surgical ablation (SA) even with the heterogeneity been noticed.…”

Section: Introductionmentioning

confidence: 99%

“…10 GP ablation has been introduced as a target in addition to PVI for AF treatment by a number of clinical trials. [11][12][13][14] But the results on the beneficial effect of adjunctive GP ablation were conflicting among different techniques. A randomized controlled trial (AFACT) 14 based on thoracoscopic AF surgery showed no reduction on AF recurrence during the 2-year follow-up, whereas other clinical trials based on CA presented a significant improvement of the outcome.…”

Section: Introductionmentioning

confidence: 99%

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Different effects of additional ganglion plexus ablation on catheter and surgical ablation for atrial fibrillation: a systemic review and meta‐analysis

Yan

Zhao

et al. 2019

Cardiovasc electrophysiol

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The effect of ganglion plexus (GP) ablation in addition to pulmonary veins isolation (PVI) for atrial fibrillation (AF) remained controversial between the catheter and surgical‐based studies. Eleven studies (five randomized controlled trials and six nonrandomized studies) of 1750 patients were included in a meta‐analysis to elucidate the incremental benefit of additional GP ablation in patients undergoing catheter or surgical ablation. Risk ratios were calculated for freedom from AF or AT recurrence after a single procedure. Additional GP ablation was associated with a better rhythm outcome for patients undergone catheter ablation but did not seem to increase freedom from AF/AT for surgical patients. Both paroxysmal and non‐paroxysmal AF showed a positive outcome comparing additional GP ablation with PVI alone.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Different effects of additional ganglion plexus ablation on catheter and surgical ablation for atrial fibrillation: a systemic review and meta‐analysis

Yan

Zhao

et al. 2019

Cardiovasc electrophysiol

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“…Physiological studies using epicardial ablation have demonstrated that the intrinsic cardiac ganglia mediate central control of cardiac function through vagal and sympathetic circuits [3][4][5] . Yet, little is known about the distribution and organization of the molecular profiles of the neurons constituting the intrinsic cardiac ganglia.…”

Section: Introductionmentioning

confidence: 99%

A spatially-tracked single cell transcriptomics map of neuronal networks in the intrinsic cardiac nervous system

Moss

Robbins

Achanta

et al. 2020

Preprint

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We developed a spatially-tracked single neuron transcriptomics map of an intrinsic cardiac ganglion - the right atrial ganglionic plexus (RAGP) that is a critical mediator of vagal control of the sinoatrial node (SAN) activity. We developed a 3D representation of RAGP with extensive mapping of neurons and used neuronal tracing to identify the spatial distribution of the subset of neurons that project to the SAN. RNAseq of laser capture microdissected neurons revealed a distinct composition of RAGP neurons compared to CNS neuronal subtypes. High-throughput qPCR of hundreds of laser capture microdissected single neurons led to a surprising finding that cholinergic and catecholaminergic neuronal markers Th and Chat were correlated, suggesting multipotential phenotypes that can drive neuroplasticity within RAGP. Interestingly, no single gene or module was an exclusive marker of RAGP neuronal connectivity to SAN. Neuropeptide-receptor coexpression analysis revealed a combinatorial paracrine neuromodulatory network within RAGP, informing follow-on studies on the vagal control of RAGP to regulate cardiac function in health and disease.

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Pulmonary vein isolation with adjunctive left atrial ganglionic plexus ablation for treatment of atrial fibrillation: a meta-analysis of randomized controlled trials

Rackley

Nudy

González

et al. 2022

J Interv Card Electrophysiol

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Additional Ganglion Plexus Ablation During Thoracoscopic Surgical Ablation of Advanced Atrial Fibrillation

Cited by 26 publications

References 24 publications

Different effects of additional ganglion plexus ablation on catheter and surgical ablation for atrial fibrillation: a systemic review and meta‐analysis

Different effects of additional ganglion plexus ablation on catheter and surgical ablation for atrial fibrillation: a systemic review and meta‐analysis

A spatially-tracked single cell transcriptomics map of neuronal networks in the intrinsic cardiac nervous system

Pulmonary vein isolation with adjunctive left atrial ganglionic plexus ablation for treatment of atrial fibrillation: a meta-analysis of randomized controlled trials

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