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Adenosine testing after second-generation cryoballoon ablation (ATSCA) study improves clinical success rate for atrial fibrillation
- Source :
- EP Europace, 17(6), 871-876. Oxford University Press
- Publication Year :
- 2015
-
Abstract
- Aims Adenosine administration after pulmonary vein (PV) isolation using radiofrequency, laser, and cryoablation can cause acute recovery of conduction to the PVs and predict atrial fibrillation (AF) recurrence. This study evaluates whether ablation of dormant potentials post-adenosine administration following second-generation cryoballoon (CB-2G) ablation may improve the success rate for AF. Methods and results In 45 of 90 patients after a waiting period of 30 min, a bolus 15-21 mg of adenosine was administered followed by rapid saline flush. The response was assessed for each PV using a circular octapolar catheter. If needed, further ablation using a cryoballoon and/or cryocatheter was performed until no reconduction was observed after repeat adenosine administration. The remaining 45 patients did not receive adenosine after the procedure. Acute PV isolation was achieved in 352 of 358 PVs (98.3%) of 86 of 90 patients (95.6%) using CB-2G. The adenosine group showed dormant reconduction in 5 of 45 patients (11%), 8 of 179 PVs (4.5%), including 1 left superior pulmonary vein, 3 left inferior pulmonary vein, 1 right superior pulmonary vein, and 3 right inferior pulmonary vein. The success rate for adenosine and without adenosine group was 84 and 79%, respectively, after a mean follow-up of 397 +/- 47 and 349 +/- 66 days, without any AF recurrence in patients in whom adenosine-induced dormant conduction was ablated. Conclusion Adenosine testing after second-generation cryoballoon ablation study showed that reablation of initially isolated PVs increases the clinical success rate for AF.
- Subjects :
- Male
medicine.medical_specialty
Adenosine
medicine.medical_treatment
Catheter ablation
Saline flush
Cryoballoon
Cryosurgery
Pulmonary vein isolation
Pulmonary vein
Bolus (medicine)
Recurrence
Physiology (medical)
Internal medicine
medicine
Humans
Aged
Retrospective Studies
business.industry
Second generation
Atrial fibrillation
Cryoablation
Middle Aged
medicine.disease
Ablation
Treatment Outcome
Pulmonary Veins
Case-Control Studies
Anesthesia
cardiovascular system
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Anti-Arrhythmia Agents
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 10995129
- Volume :
- 17
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- EP Europace
- Accession number :
- edsair.doi.dedup.....26de0db02bfef7bb70e00f4b729c5914