Left atrial ganglionic plexi and AF ablation

Left atrial ganglionic plexi and AF ablation

Left atrial ganglionic plexi are relatively new targets of AF (atrial fibrillation) ablation. The four major left atrial ganglionic plexi are superior left ganglionic plexus, inferior left ganglionic plexus, anterior right ganglionic plexus and inferior right ganglionic plexus. They are located in epicardial fat pads at the border of the pulmonary vein antrum. The ganglionic plexi can be localized at the time of ablation using endocardial high frequency stimulation (HFS). They can be ablated by radiofrequency (RF) current application at endocardial sites with a positive vagal response to high frequency stimulation. High frequency stimulation is repeated and additional radiofrequency current applications can be applied until the vagal response to high frequency stimulation is eliminated.