Non–Pulmonary Vein Triggers—Does Sex Matter?

Non-pulmonary vein (PV) triggers can play a role in initiating atrial fibrillation (AF) and potentially contributing to AF recurrence after PV isolation. 1The complete weight of sex on AF ablation strategies and outcomes remains controversial due to mixed data. [2][3]3][4] However, data on sex-specific differences in non-PV triggers remain limited.Chaumont et al 5 report the results of a prospective cohort study of patients undergoing firsttime AF ablation from the Hospital of the University of Pennsylvania AF ablation registry between January 2020 and December 2022.The initial study on the stepwise non-PV triggers provocation protocols and mapping for these patients was published in 2024. 6In this current study, Chaumont et al 5 examine sex-related differences in the types, prevalence, and site of origin of non-PV triggers.Non-PV triggers were defined as atrial ectopic beats triggering atrial tachycardia or AF, excluding atrioventricular nodal reentrant tachycardia and atrioventricular reentrant tachycardia.The authors included 2038 patients who underwent first-time AF-ablation and non-PV trigger provocation.Of those, 67.2% were men, and 32.8% were women.They found the prevalence of non-PV triggers