title: Dissociated pulmonary vein rhythm may predict the acute pulmonary vein reconnection post-isolation in patients with paroxysmal atrial fibrillation.
abstract: OBJECTIVE
  Dissociated pulmonary vein rhythm (PVD) has been taken as a signal of PV isolation, but has been questioned recently; we assessed the relationship between PVD and acute PV reconnection after PV isolation in this study.
  
  
  RESULTS
  Eighty-five consecutive patients (52 males; mean age 59±11 years) were referred for catheter ablation of drug-refractory paroxysmal AF. Following PV isolation, the presence and cycle length of PVD were recorded. Pulmonary veins were classified into veins with PVD (Group 1) and veins without PVD (Group 2). Adenosine triphosphate (ATP) was then injected during isoproterenol infusion to reveal dormant conduction gap(s), and PVs were further remapped at 30 min post-isolation. Totally, PVD was observed in 68% (58 of 85) of patients and 34.7% (112 of 323) of PVs. Seventy-nine (24.5%) PVs were found acutely reconnected, including 48 veins revealed by ATP induction [ATP(+)PV] and 64 veins by reassessment after 30 min post-isolation [Time(+)PV]. Time(+)PVs were observed more frequently in Group 1 than those in Group 2 (31.3 vs. 13.7%, P<0.01), but no significant difference was found in the occurrence of ATP(+)PVs between Group 1 and Group 2 (17.9 vs. 13.3%, P=0.27). The sequences of the PVD and the acutely reconnected PV potential were similar in 87.5% of veins. After PV re-isolation, 70% (28 of 40) of previously documented PVD disappeared.
  
  
  CONCLUSIONS
  The occurrence of PVD after PV isolation was closely related to the acute PV reconnection after 30 min post-isolation.
authors.affiliation: SIR RUN RUN SHAW Institut universitaire de cardiologie et de pneumologie de Québec, Canada. jiangchenyang@hotmail.com
authors.forename: Chen-yang
authors.initials: CY
authors.lastname: Jiang
authors.forename: Jian-wei
authors.initials: JW
authors.lastname: Fu
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Matsuo
authors.forename: Isabelle
authors.initials: I
authors.lastname: Nault
authors.forename: Hong
authors.initials: H
authors.lastname: He
authors.forename: Ru-hong
authors.initials: RH
authors.lastname: Jiang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Liu
authors.forename: You-qi
authors.initials: YQ
authors.lastname: Fan
authors.forename: Xia
authors.initials: X
authors.lastname: Sheng
authors.forename: Zhu-wen
authors.initials: ZW
authors.lastname: Zhang
authors.forename: Guo-sheng
authors.initials: GS
authors.lastname: Fu
mesh_terms: D000255:Adenosine Triphosphate / Q000494:pharmacology; D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006329:Heart Conduction System / Q000187:drug effects / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011667:Pulmonary Veins / Q000503:physiopathology* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000255:Adenosine Triphosphate