Introduction and Objectives: To identify the location of the left atrial ganglionated plexi (GPs) based on dense epicardial mapping during in patients with concomitant atrial fibrillation.
Methods: Sixteen patients (68 ± 10 years; 11 males (69%))with heart failure and concomitant atrial fibrillation (duration 55 ± 86 months) underwent intraoperative epicardial electrophysiological mapping and a GP ablation using the maze procedure. Twenty-four site, high-frequency stimulation (1000/min; 18 V) was performed by placing tweezers directly onto the potential GP sites on the left atrial epicardium.
Results: Active GPs were found in 13 (81%) of the 16 patients, and 12 (92%) of 13 patients had active GPs between the right pulmonary veins and the interatrial groove. For those patients with active locations, a 7-day event-loop recording demonstrated that 12 (92%) out of 13 patients were maintained in sinus rhythm 3 months after the operation.
Conclusions: Dense epicardial mapping in the potential GP areas identified active GP locations in a high percentage of patients. GPs between the pulmonary veins and interatrial groove have a high potential as ablation targets for treatment of concomitant atrial fibrillation.