Transient atriovenous reconnection induced by adenosine after successful pulmonary vein isolation with the cryothermal energy balloon.
OBJECTIVE
Cryothermal energy balloon ablation (CBA), using cryogenic ablative energy, has proven very effective in producing pulmonary vein (PV) isolation in patients with paroxysmal atrial fibrillation (AF). Adenosine testing after PV isolation has demonstrated to be able to unmask incomplete lesion after radiofrequency (RF) ablation. The aim of our study was to assess the rate of transient atriovenous reconnection induced by adenosine after successful PV isolation with the CBA in a group of patients with paroxysmal AF.


RESULTS
We prospectively enrolled 39 patients (31 male; age 59 +/- 11 years) elected to circumferential PV isolation with CBA for highly symptomatic paroxysmal AF. A total of 149 PVs were evidenced. Adenosine testing after CBA induced a left atrium-PV reconnection only in 7 (4.6%) of PV.


CONCLUSIONS
Our study showed a low rate of transient PV reconnection after adenosine infusion following successful PV isolation with CBA. However, larger studies will be needed in order to confirm our findings and the prognostic value of adenosine testing after successful PV isolation obtained with CBA.
Chierchia
Gian Battista
GB
Heart Rhythm Management Centre, UZ Brussel-VUB, Laarbeeklaan 101, Brussels, Belgium. gbchier@yahoo.it
Yazaki
Yoshinao
Y
Sorgente
Antonio
A
Capulzini
Lucio
L
de Asmundis
Carlo
C
Sarkozy
Andrea
A
Duytschaever
Matthias
M
De Ponti
Roberto
R
Brugada
Pedro
P
D000241:Adenosine; D000889:Anti-Arrhythmia Agents; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D001283:Atrioventricular Node / Q000187:drug effects; D017115:Catheter Ablation / Q000379:methods*; D003452:Cryosurgery / Q000379:methods*; D004562:Electrocardiography / Q000187:drug effects*; D005260:Female; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011667:Pulmonary Veins / Q000601:surgery*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D000241:Adenosine