Background Adenosine can be used to reveal dormant pulmonary vein (PV) conduction after PV isolation (PVI). This study presents a subanalysis of real-world 1-year follow-up data from the ESC-EHRA EORP Atrial Fibrillation (AF) Ablation Long-Term registry to analyze the usage of adenosine during PVI treatment in terms of rhythm outcome and safety. Methods The registry consists of 104 participating centers in 27 countries within the European Society of Cardiology. The registry data was split into an adenosine group (AG) and no-adenosine group (NAG). Procedure characteristics and patient outcome were compared. Results Adenosine was administered in 10.8% of the 3591 PVI patients included in the registry. Spain, the Netherlands, and Italy included the majority of adenosine cases (48.8%). Adenosine was applied more often in combination with open irrigation radiofrequency (RF) energy (74.7%) and less often in combination with nonirrigated RF energy (1.6%). After 1 year, a higher percentage of the AG was free from AF compared with the NAG (68.9% vs 59.1%, p < 0.001). Adenosine was associated with better rhythm outcome in RF ablation procedures, but not in cryo-ablation procedures (freedom from AF: RF: AG: 70.9%, NAG: 58.1%, p < 0.001, cryo: AG: 63.9%, NAG: 63.8%, p = 0.991). Conclusions The use of adenosine was associated with a better rhythm outcome after 1 year follow-up and seems more useful in patients treated with RF energy compared with patients treated with cryo energy. Given the improved rhythm outcome at 1-year follow-up, it seems reasonable to encourage the use of adenosine during RF AF ablation.

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One of the reasons leading to dilatation of the left atrium is atrial fibrillation. A retrospective analysis of 136 case histories of patients with various forms of “non-valvular” atrial fibrillation was performed, depending on the shape of atrial fibrillation, the patients were divided into 3 groups. In patients with atrial fibrillation in 62.5%, the source of the atrial branches was the envelope branch of the left coronary artery. Atrial branches originating from the right coronary artery system were identified in 35.8%. In men, atrial arteries occur significantly more often. The results differ from publications, according to which the blood supply of the atria and sinoatrial node from 60 to 75% is carried out by branches departing from the basin of the right coronary artery. The degree of dilatation of the left atrium does not depend on the source of blood supply, but a correlation between the size of the left atrium and the diameter of the branches of the artery of the sinatrial node in the group of patients with paroxysmal atrial fibrillation is traced.