title: Adenosine sensitivity is associated with ablation success rate and recurrence rate with nonirrigated catheters in patients with ventricular premature contractions/tachycardia from the ventricular outflow tract.
abstract: BACKGROUND
  A high ablation success rate for ventricular arrhythmia (VA) from outflow tract has been achieved, but some of them cannot be eliminated from endocardium. We investigated the association between adenosine sensitivity and ablation success/recurrence rates with a nonirrigated or an irrigated catheter.
  
  
  METHODS
  According to adenosine test, all patients were divided into a sensitive group (S group) or an insensitive group (I group). The patients of each group were randomized into a nonirrigated catheter (NA) subgroup or an irrigated catheter (IA) subgroup with a 2:1 ratio.
  
  
  RESULTS
  In S group of 122 patients (84 in NA subgroup), the ablation success rate was similar between two subgroups (94.7% vs. 90.5%, P > 0.05), but in I group of 94 patients (60 in NA subgroup), it was higher in IA subgroup (94.1%) than that in NA subgroup (73.3%, P < 0.05). The success rate using nonirrigated catheter was significantly higher in S group (90.5%) than that in I group (73.3%, P < 0.01), and the recurrence rate was lower in S group than that in I group (1.3%, vs. 13.6%, P < 0.05). On the contrary, the success rate and the recurrence rate using irrigated catheter were similar between S group and I group (94.7%, 94.1%, P > 0.05, vs. 2.8%, 6.3%, P > 0.05).
  
  
  CONCLUSIONS
  Adenosine insensitivity is associated with a lower success rate and a higher recurrence rate for VA patients undergoing nonirrigated catheter ablation. Thus, irrigated catheters should be the first choice for VA ablation in adenosine insensitive patients.
authors.forename: Xiang-Fei
authors.initials: XF
authors.lastname: Feng
authors.forename: Qun-Shan
authors.initials: QS
authors.lastname: Wang
authors.forename: Jian
authors.initials: J
authors.lastname: Sun
authors.forename: Rui
authors.initials: R
authors.lastname: Zhang
authors.forename: Peng-Pai
authors.initials: PP
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.forename: Da-Li
authors.initials: DL
authors.lastname: Feng
authors.affiliation: Department of Cardiology, Xinhua Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, China.
authors.forename: Yi-Gang
authors.initials: YG
authors.lastname: Li
mesh_terms: D000241:Adenosine / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000818:Animals; D017115:Catheter Ablation; D006352:Heart Ventricles / Q000187:drug effects / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000188:drug therapy* / Q000601:surgery*; D016896:Treatment Outcome; D018879:Ventricular Premature Complexes / Q000188:drug therapy* / Q000601:surgery*
chemical_list: D000241:Adenosine