Background: The role of the pulmonary veins (PVs) as triggers in atrial fibrillation (AF) is well-known; however, their detailed electrophysiological properties have not been thoroughly examined.
Objective: This study aimed to investigate the electrophysiological properties of the PVs between paroxysmal AF (pAF) and persistent AF (perAF).
Methods: Prior to catheter ablation in patients with pAF (n = 51) and perAF (n = 41), a voltage map of the left atrium and PVs was created under sinus rhythm, and the area of the myocardial sleeves in the PVs and their electrophysiological characteristics, including the pacing threshold and effective refractory period (ERP), were compared between the two groups.
Results: Compared with perAF, the myocardial sleeves of PVs for pAF were significantly larger for all PVs. The ERP for perAF was significantly shorter than that for pAF for all PVs. The pacing threshold for perAF was significantly higher than that for pAF for the right and left superior PVs.
Conclusion: In patients with perAF, a decrease in the normal myocardial sleeves and a shortening of the ERP were observed for all PVs. Those changes in the electrophysiological properties of the PVs might be related to the persistence of AF.
Keywords: atrial fibrillation; electrophysiological study; low‐voltage areas; pulmonary vein; substrate.
© 2023 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.