Comparison of the clinical outcome after pulmonary vein isolation based on the appearance of adenosine-induced dormant pulmonary vein conduction.
BACKGROUND
The elimination of transient pulmonary vein (PV) reconduction (dormant PV conduction) revealed by adenosine in addition to PV isolation reduced the atrial fibrillation (AF) recurrence after catheter ablation. The dormant PV conduction is induced in approximately half of the AF patients that undergo PV isolation. The present study compared the clinical outcome of AF ablation in patients whose dormant PV conduction was eliminated by additional radiofrequency applications with the outcome in patients without dormant conduction.


METHODS
A total of 233 consecutive patients (206 male, 54.2 +/- 10.1 years) that underwent AF ablation were included in the present study. Dormant PV conduction was induced by the administration of adenosine triphosphate after PV isolation and was eliminated by supplemental radiofrequency application. All patients were followed up for >12 months (mean 903 days) after the first ablation.


RESULTS
Following PV isolation, dormant PV conduction was induced in 139 (59.7%) of 233 patients and was successfully eliminated in 98% (223/228) of those in the first ablation procedure. After the first procedure, 63.9% (149/233) of patients were free from AF recurrence events. The success rates of a single or final AF ablation in patients with the appearance of the dormant PV conduction were similar to those of patients without dormant conduction (P = .69 and P = .69, respectively).


CONCLUSIONS
Dormant PV conduction was induced in over half of the patients with AF. After the elimination of adenosine triphosphate-induced reconnection, the clinical outcome of patients with the dormant PV conduction was equivalent to that of patients without conduction.
Matsuo
Seiichiro
S
Department of Cardiology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan. mattsuu@tc4.so-net.ne.jp
Yamane
Teiichi
T
Date
Taro
T
Hioki
Mika
M
Ito
Keiichi
K
Narui
Ryohsuke
R
Tanigawa
Shin-ichi
S
Nakane
Tokiko
T
Hama
Yoshiyuki
Y
Tokuda
Michifumi
M
Yamashita
Seigo
S
Aramaki
Yasuko
Y
Inada
Keiichi
K
Shibayama
Kenri
K
Miyanaga
Satoru
S
Yoshida
Hiroshi
H
Miyazaki
Hidekazu
H
Abe
Kunihiko
K
Sugimoto
Ken-ichi
K
Taniguchi
Ikuo
I
Yoshimura
Michihiro
M
D000255:Adenosine Triphosphate / Q000494:pharmacology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006329:Heart Conduction System / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome
D000255:Adenosine Triphosphate