Narendra Kumar1, Trang Dinh2, Kevin Phan3, Carl Timmermans2, Suzanne Philippens2, Willem Dassen2, Nousjka Vranken2, Laurent Pison2, Jos Maessen2, Harry J Crijns2. 1. Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht 6202 AZ, The Netherlands narendra.kumar@maastrichtuniversity.nl. 2. Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht 6202 AZ, The Netherlands. 3. Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia.
Abstract
AIMS: Adenosine administration after pulmonary vein (PV) isolation using radiofrequency, laser, and cryoablation can cause acute recovery of conduction to the PVs and predict atrial fibrillation (AF) recurrence. This study evaluates whether ablation of dormant potentials post-adenosine administration following second-generation cryoballoon (CB-2G) ablation may improve the success rate for AF. METHODS AND RESULTS: In 45 of 90 patients after a waiting period of 30 min, a bolus 15-21 mg of adenosine was administered followed by rapid saline flush. The response was assessed for each PV using a circular octapolar catheter. If needed, further ablation using a cryoballoon and/or cryocatheter was performed until no reconduction was observed after repeat adenosine administration. The remaining 45 patients did not receive adenosine after the procedure. Acute PV isolation was achieved in 352 of 358 PVs (98.3%) of 86 of 90 patients (95.6%) using CB-2G. The adenosine group showed dormant reconduction in 5 of 45 patients (11%), 8 of 179 PVs (4.5%), including 1 left superior pulmonary vein, 3 left inferior pulmonary vein, 1 right superior pulmonary vein, and 3 right inferior pulmonary vein. The success rate for adenosine and without adenosine group was 84 and 79%, respectively, after a mean follow-up of 397 ± 47 and 349 ± 66 days, without any AF recurrence in patients in whom adenosine-induced dormant conduction was ablated. CONCLUSION: Adenosine testing after second-generation cryoballoon ablation study showed that reablation of initially isolated PVs increases the clinical success rate for AF. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Adenosine administration after pulmonary vein (PV) isolation using radiofrequency, laser, and cryoablation can cause acute recovery of conduction to the PVs and predict atrial fibrillation (AF) recurrence. This study evaluates whether ablation of dormant potentials post-adenosine administration following second-generation cryoballoon (CB-2G) ablation may improve the success rate for AF. METHODS AND RESULTS: In 45 of 90 patients after a waiting period of 30 min, a bolus 15-21 mg of adenosine was administered followed by rapid saline flush. The response was assessed for each PV using a circular octapolar catheter. If needed, further ablation using a cryoballoon and/or cryocatheter was performed until no reconduction was observed after repeat adenosine administration. The remaining 45 patients did not receive adenosine after the procedure. Acute PV isolation was achieved in 352 of 358 PVs (98.3%) of 86 of 90 patients (95.6%) using CB-2G. The adenosine group showed dormant reconduction in 5 of 45 patients (11%), 8 of 179 PVs (4.5%), including 1 left superior pulmonary vein, 3 left inferior pulmonary vein, 1 right superior pulmonary vein, and 3 right inferior pulmonary vein. The success rate for adenosine and without adenosine group was 84 and 79%, respectively, after a mean follow-up of 397 ± 47 and 349 ± 66 days, without any AF recurrence in patients in whom adenosine-induced dormant conduction was ablated. CONCLUSION:Adenosine testing after second-generation cryoballoon ablation study showed that reablation of initially isolated PVs increases the clinical success rate for AF. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Heart Rhythm Date: 2017-05-12 Impact factor: 6.343
Authors: Hugh Calkins; Karl Heinz Kuck; Riccardo Cappato; Josep Brugada; A John Camm; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; John DiMarco; James Edgerton; Kenneth Ellenbogen; Michael D Ezekowitz; David E Haines; Michel Haissaguerre; Gerhard Hindricks; Yoshito Iesaka; Warren Jackman; José Jalife; Pierre Jais; Jonathan Kalman; David Keane; Young-Hoon Kim; Paulus Kirchhof; George Klein; Hans Kottkamp; Koichiro Kumagai; Bruce D Lindsay; Moussa Mansour; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Douglas L Packer; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Vivek Reddy; Jeremy N Ruskin; Richard J Shemin; Hsuan-Ming Tsao; David Wilber Journal: Heart Rhythm Date: 2012-03-01 Impact factor: 6.343
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Europace Date: 2018-01-01 Impact factor: 5.214
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