Imperial College London

Dr Fu Siong Ng

Faculty of MedicineNational Heart & Lung Institute

Clinical Senior Lecturer in Cardiac Electrophysiology



+44 (0)20 7594 Website




ICTEM buildingHammersmith Campus






BibTex format

author = {Kim, M-Y and Sandler, B and Sikkel, MB and Cantwell, CD and Leong, KM and Luther, V and Malcolme-Lawes, L and Koa-Wing, M and Ng, FS and Qureshi, N and Sohaib, A and Whinnett, ZI and Fudge, M and Lim, E and Todd, M and Wright, I and Peters, NS and Lim, PB and Linton, NWF and Kanagaratnam, P},
doi = {10.1016/j.autneu.2020.102699},
journal = {Autonomic Neuroscience},
title = {The ectopy-triggering ganglionated plexuses in atrial fibrillation},
url = {},
volume = {228},
year = {2020}

RIS format (EndNote, RefMan)

AB - BackgroundEpicardial ganglionated plexus (GP) have an important role in the pathogenesis of atrial fibrillation (AF). The relationship between anatomical, histological and functional effects of GP is not well known. We previously described atrioventricular (AV) dissociating GP (AVD-GP) locations. In this study, we hypothesised that “ET-GP” are upstream triggers of atrial ectopy/AF and have different anatomical distribution to AVD-GP.ObjectivesWe mapped and characterised ET-GP to understand their neural mechanism in AF and anatomical distribution in the left atrium (LA).Methods26 patients with paroxysmal AF were recruited. All were paced in the LA with an ablation catheter. HFS (80ms) was synchronised to each paced stimulus (after 20ms delay) for delivery within the local atrial refractory period. HFS responses were tagged onto CARTO™ 3D LA geometry. All geometries were transformed onto one reference LA shell. A probability distribution atlas of ET-GP was created. This identified high/low ET-GP probability regions.Results2302 sites were tested with HFS, identifying 579 (25%) ET-GP. 464 ET-GP were characterised, where 74 (16%) triggered ≥30s AF/AT. Median 97 (IQR 55) sites were tested, identifying 19 (20%) ET-GP per patient. >30% of ET-GP were in the roof, mid-anterior wall, around all PV ostia except in the right inferior PV (RIPV) in the posterior wall.ConclusionET-GP can be identified by endocardial stimulation and their anatomical distribution, in contrast to AVD-GP, would be more likely to be affected by wide antral circumferential ablation. This may contribute to AF ablation outcomes.
AU - Kim,M-Y
AU - Sandler,B
AU - Sikkel,MB
AU - Cantwell,CD
AU - Leong,KM
AU - Luther,V
AU - Malcolme-Lawes,L
AU - Koa-Wing,M
AU - Ng,FS
AU - Qureshi,N
AU - Sohaib,A
AU - Whinnett,ZI
AU - Fudge,M
AU - Lim,E
AU - Todd,M
AU - Wright,I
AU - Peters,NS
AU - Lim,PB
AU - Linton,NWF
AU - Kanagaratnam,P
DO - 10.1016/j.autneu.2020.102699
PY - 2020///
SN - 1566-0702
TI - The ectopy-triggering ganglionated plexuses in atrial fibrillation
T2 - Autonomic Neuroscience
UR -
UR -
UR -
VL - 228
ER -