title: Reduction of AF recurrence after pulmonary vein isolation by eliminating ATP-induced transient venous re-conduction.
abstract: BACKGROUND
  Recent evidence has suggested that the transient re-conduction of the isolated pulmonary vein (PV) induced by the intravenous injection of adenosine (dormant PV conduction) might predict the incidence of subsequent venous reconnection after the procedure, which is the main cause of the atrial fibrillation (AF) recurrence after PV isolation (PVI). We tested the hypothesis that the elimination of these dormant PV conductions by additional radiofrequency (RF) applications can improve the efficacy of the PVI.
  
  
  RESULTS
  One hundred forty-eight patients (124 males; mean age 53 +/- 9 years) with drug-refractory AF underwent the PVI procedure. The standard PVI was performed in 94 patients (Group A), whereas the elimination of adenosine triphosphate (ATP)-induced dormant conduction using additional RF energy was performed in addition to the standard PVI in other 54 patients (Group B). Dormant conduction was observed in 56% of the patients (30/54) in Group B and 95% of these transient re-conductions were successfully eliminated by additional RF applications (mean: 1.5 +/- 1.0 times). During the mean follow-up period of 20 months, recurrences of AF after the procedures were observed significantly less frequently in Group B (20%) than in Group A (40%) (P < 0.05).
  
  
  CONCLUSIONS
  The use of additional RF applications to eliminate transient PV reconnection induced by ATP injection led to a reduction of AF recurrence after PVI, most likely due to the minimization of the subsequent PV reconnection.
authors.affiliation: Department of Cardiology, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Matsuo
authors.forename: Teiichi
authors.initials: T
authors.lastname: Yamane
authors.forename: Taro
authors.initials: T
authors.lastname: Date
authors.forename: Keiichi
authors.initials: K
authors.lastname: Inada
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Kanzaki
authors.forename: Michifumi
authors.initials: M
authors.lastname: Tokuda
authors.forename: Kenri
authors.initials: K
authors.lastname: Shibayama
authors.forename: Satoru
authors.initials: S
authors.lastname: Miyanaga
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Miyazaki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Seibu
authors.initials: S
authors.lastname: Mochizuki
mesh_terms: D000255:Adenosine Triphosphate; D000328:Adult; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000187:drug effects* / Q000502:physiology; D012189:Retrospective Studies
chemical_list: D000255:Adenosine Triphosphate