title: Adenosine testing during cryoballoon ablation and radiofrequency ablation of atrial fibrillation: A propensity score-matched analysis.
abstract: The infusion of adenosine triphosphate after radiofrequency (RF) pulmonary vein (PV) isolation (PVI), which may result in acute transient PV-atrium reconnection, can unmask dormant conduction.
  
  
  
  The purpose of this study was to compare the incidence and characteristics of dormant conduction after cryoballoon (CB) and RF ablation of atrial fibrillation (AF).
  
  
  
  Of 414 consecutive patients undergoing initial catheter ablation of paroxysmal AF, 246 (59%) propensity score-matched patients (123 CB-PVI and 123 RF-PVI) were included.
  
  
  
  Dormant conduction was less frequently observed in patients who underwent CB-PVI than in those who underwent RF-PVI (4.5% vs 12.8% of all PVs; P < .0001). The incidence of dormant conduction in each PV was lower in patients who underwent CB-PVI than in those who underwent RF-PVI in the left superior PV (P < .0001) and right superior PV (P = .001). The site of dormant conduction was mainly located around the bottom of both inferior PVs after CB-PVI. Multivariable analysis revealed that a longer time to the elimination of the PV potential (odds ratio 1.018; 95% confidence interval 1.001-1.036; P = .04) and the necessity of touch-up ablation (odds ratio 3.242; 95% confidence interval 2.761-7.111; P < .0001) were independently associated with the presence of dormant conduction after CB-PVI. After the elimination of dormant conduction by additional ablation, the AF-free rate was similar in patients with and without dormant conduction after both CB-PVI and RF-PVI (P = .28 and P = .73, respectively).
  
  
  
  The results of the propensity score-matched analysis showed that dormant PV conduction was less frequent after CB ablation than after RF ablation and was not associated with ablation outcomes.
authors: Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan. Electronic address: tokudam@gmail.com.
authors: Michifumi
authors: M
authors: Tokuda
authors: Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
authors: Seiichiro
authors: S
authors: Matsuo
authors: Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
authors: Ryota
authors: R
authors: Isogai
authors: Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
authors: Goki
authors: G
authors: Uno
authors: Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
authors: Kenichi
authors: K
authors: Tokutake
authors: Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
authors: Kenichi
authors: K
authors: Yokoyama
authors: Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
authors: Mika
authors: M
authors: Kato
authors: Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
authors: Ryohsuke
authors: R
authors: Narui
authors: Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
authors: Shinichi
authors: S
authors: Tanigawa
authors: Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
authors: Seigo
authors: S
authors: Yamashita
authors: Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
authors: Keiichi
authors: K
authors: Inada
authors: Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
authors: Michihiro
authors: M
authors: Yoshimura
authors: Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
authors: Teiichi
authors: T
authors: Yamane
mesh_terms: D000255:Adenosine Triphosphate / Q000008:administration & dosage*; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D002317:Cardiovascular Agents / Q000008:administration & dosage; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods; D005260:Female; D006329:Heart Conduction System / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D011667:Pulmonary Veins / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D000255:Adenosine Triphosphate
keywords: Ablation; Adenosine; Atrial fibrillation; Cryoballoon; Dormant conduction; Outcome; Pulmonary vein; Radiofrequency