Comparison of the clinical outcome after pulmonary vein isolation based on the appearance of adenosine-induced dormant pulmonary vein conduction

Matsuo, Seiichiro; Yamane, Teiichi; Date, Taro; Hioki, Mika; Ito, Keiichi; Narui, Ryohsuke; Tanigawa, Shin‐ichi; Nakane, Tokiko; Hama, Yuka; Tokuda, Michifumi; Yamashita, Seigo; Aramaki, Yasuko; Inada, Keiichi; Shibayama, Kentaro; Miyanaga, Satoru; Yoshida, Hiroshi; Miyazaki, Hidekazu; Abe, Kunihiko; Sugimoto, Kunihisa; Taniguchi, Ikuo; Yoshimura, Michihiro

doi:10.1016/j.ahj.2010.05.025

Cited by 33 publications

(36 citation statements)

References 20 publications

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“…Twenty-four (60%) patients were male, the mean age was 58 ± 12 years, and the mean left atrial diameter was 39 ± 5 mm. The mean procedure time for PVI procedures was 164 ± 34 minutes, with a mean ablation time of 43 ± 9 minutes and a median fluoroscopy time of 11 [8][9][10][11][12][13][14][15][16] minutes. One major complication (right phrenic nerve palsy) occurred following the initial PVI procedures.…”

Section: Resultsmentioning

confidence: 99%

“…As in our study, Matsuo et al . found no difference in late reconnection between PVs with and without adenosine‐mediated acute reconnection (54% vs. 59%, P = 0.53), with the majority of chronically reconnected PVs (74%) having not been acutely reconnected . Conversely, another study found a trend toward a higher rate of late reconnection at redo ablation for PVs with dormant conduction (82%) compared to those without (49%) .…”

Section: Discussionmentioning

confidence: 97%

“…11,12 This may preclude the subsequent delivery of transmural ablation at the same site. Previous studies have compared sites of acute reconnection with late reconnection sites identified from redo procedures for clinical arrhythmia recurrence, [13][14][15] but this has never been investigated systematically. We therefore aimed to determine prospectively whether sites of acute reconnection, despite reablation, predict sites of late reconnection at repeat electrophysiology study 2 months post-PVI.…”

Section: Introductionmentioning

confidence: 99%

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Reablated Sites of Acute Reconnection After Pulmonary Vein Isolation Do Not Predict Sites of Late Reconnection at Repeat Electrophysiology Study

Das

Wynn

Morgan

et al. 2016

Cardiovasc electrophysiol

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Reablated Sites of Acute Reconnection After Pulmonary Vein Isolation Do Not Predict Sites of Late Reconnection at Repeat Electrophysiology Study

Das

Wynn

Morgan

et al. 2016

Cardiovasc electrophysiol

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show abstract

“…[6][7][8][9] The role of additional ablation guided by adenosine testing for DC is unclear. Although 1 study showed similar rates of freedom from AF among patients with and without adenosine-induced PV reconnection after DC was targeted, 10 another study found higher AF recurrence rates among patients with DC even after additional ablation.…”

mentioning

confidence: 99%

Adenosine-Induced Pulmonary Vein Ectopy as a Predictor of Recurrent Atrial Fibrillation After Pulmonary Vein Isolation

Cheung

Lin

et al. 2013

Circ: Arrhythmia and Electrophysiology

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Background— Adenosine can unmask dormant pulmonary vein (PV) conduction after PV isolation. Adenosine can also induce ectopy in electrically silent PVs after isolation, possibly via activation of autonomic triggers. We sought to identify the implications of adenosine-induced PV ectopy for atrial fibrillation (AF) recurrence after PV isolation. Methods and Results— A total of 152 patients (age, 60±11 years; 63% paroxysmal AF) undergoing PV isolation for AF were studied. After each PV was isolated, adenosine was administered and the presence of adenosine-induced PV reconnection and PV ectopy were recorded. Dormant conduction was targeted with additional ablation. Adenosine-induced PV ectopy was seen in 45 (30%) patients, and dormant conduction was seen in 44 (29%) patients. After a median follow-up of 374 days, 48 (32%) patients had recurrent AF after a single ablation procedure. Rates of freedom from AF among patients with adenosine-induced PV ectopy were significantly lower than patients without adenosine-induced PV ectopy (63% versus 76% at 1 year; log rank, 0.014). Rates of freedom from AF among patients with dormant conduction were also lower than patients without dormant conduction (64% versus 76% at 1 year; log rank, 0.062). With multivariate analysis, adenosine-induced PV ectopy was found to be the only independent predictor of AF after PV isolation (hazard ratio, 1.90; 95% confidence interval, 1.06–3.40; P =0.032). Conclusions— Adenosine-induced PV ectopy is a predictor of recurrent AF after PV isolation and may be a marker of increased susceptibility to autonomic triggers of AF.

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“…Testing for dormant conduction by infusion of adenosine or isoproterenol has been used to unmask areas of the LA‐PV junction that are still capable of conduction . Elimination of dormant conduction may improve outcome after PVI; however, the results of the published studies are not unequivocal . The ADVICE study is a prospective randomized trial and has been designed to assess whether elimination of dormant conduction unmasked by adenosine will decrease the rate of recurrent AF compared with standard PVI.…”

Section: Discussionmentioning

confidence: 99%

Prolonged Ablation on Critical Segments of Pulmonary Vein Ostia in Paroxysmal Atrial Fibrillation: A Prospective Randomized Controlled Study

Kriatselis¹,

Kaufmann²,

Nedios³

et al. 2013

Pacing Clinical Electrophis

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Comparison of the clinical outcome after pulmonary vein isolation based on the appearance of adenosine-induced dormant pulmonary vein conduction

Cited by 33 publications

References 20 publications

Reablated Sites of Acute Reconnection After Pulmonary Vein Isolation Do Not Predict Sites of Late Reconnection at Repeat Electrophysiology Study

Reablated Sites of Acute Reconnection After Pulmonary Vein Isolation Do Not Predict Sites of Late Reconnection at Repeat Electrophysiology Study

Adenosine-Induced Pulmonary Vein Ectopy as a Predictor of Recurrent Atrial Fibrillation After Pulmonary Vein Isolation

Prolonged Ablation on Critical Segments of Pulmonary Vein Ostia in Paroxysmal Atrial Fibrillation: A Prospective Randomized Controlled Study

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