Ya-Lei Niu1, Shih-Lin Chang2, Yenn-Jiang Lin2, Li-Wei Lo2, Yu-Feng Hu3, Ta-Chuan Tuan3, Chin-Feng Tsai4, Wei-Shiang Lin5, Hsuan-Ming Tsao6, Shih-Ann Chen2. 1. Division of Cardiology, Department of Internal Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua; 2. Department of Medicine and Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University School of Medicine; ; Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei; 3. Department of Medicine and Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University School of Medicine; 4. Department of Cardiology, Chung Shan Medical University Hospital, Taichung; 5. Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital; 6. Department of Medicine and Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University School of Medicine; ; Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei; ; Division of Cardiology, Department of Internal Medicine, National Yang-Ming University Hospital, Taipei, Taiwan.
Abstract
BACKGROUND: Dissociated activity can occur after circumferential thoracic vein isolation for treating atrial fibrillation (AF). However, its clinical significance and response to adenosine remain unclear. METHODS: Fifty-three patients (10 women, 11 with non-paroxysmal AF, with mean age 54.4 ± 11.2 years) with slow dissociated activity after thoracic vein isolation for AF ablation were analyzed. Adenosine (12 mg) was injected intravenously into 30 patients, and the responses of the dissociated activities were recorded. RESULTS: The clinical characteristics and the rate of recurrence did not differ between patients with and without dissociated activity. Dissociated activity was most frequently observed at the right superior pulmonary vein (PV) (61%), left superior PV (26%), right inferior PV (5%), left inferior PV (4%), and non-PV sites (4%). The locations of dissociated activities were associated with the AF trigger sites (p = 0.004). Adenosine injection decreased the cycle length of dissociated activity in 13 patients (group 1) and increased it in 17 patients (group 2). Dissociated activity disappeared in 7 patients (41%) (group 2) after adenosine injection. During the mean 33 ± 17 months of follow-up, group 2 patients had a lower AF recurrence rate (24%) than group 1 patients (62%) (p = 0.035). CONCLUSIONS: The locations of dissociated activity were closely associated with the AF trigger sites. The responses to adenosine may predict AF recurrence in patients with dissociated activity. KEY WORDS: Ablation; Atrial fibrillation; Dissociated activity.
BACKGROUND: Dissociated activity can occur after circumferential thoracic vein isolation for treating atrial fibrillation (AF). However, its clinical significance and response to adenosine remain unclear. METHODS: Fifty-three patients (10 women, 11 with non-paroxysmal AF, with mean age 54.4 ± 11.2 years) with slow dissociated activity after thoracic vein isolation for AF ablation were analyzed. Adenosine (12 mg) was injected intravenously into 30 patients, and the responses of the dissociated activities were recorded. RESULTS: The clinical characteristics and the rate of recurrence did not differ between patients with and without dissociated activity. Dissociated activity was most frequently observed at the right superior pulmonary vein (PV) (61%), left superior PV (26%), right inferior PV (5%), left inferior PV (4%), and non-PV sites (4%). The locations of dissociated activities were associated with the AF trigger sites (p = 0.004). Adenosine injection decreased the cycle length of dissociated activity in 13 patients (group 1) and increased it in 17 patients (group 2). Dissociated activity disappeared in 7 patients (41%) (group 2) after adenosine injection. During the mean 33 ± 17 months of follow-up, group 2 patients had a lower AF recurrence rate (24%) than group 1 patients (62%) (p = 0.035). CONCLUSIONS: The locations of dissociated activity were closely associated with the AF trigger sites. The responses to adenosine may predict AF recurrence in patients with dissociated activity. KEY WORDS: Ablation; Atrial fibrillation; Dissociated activity.
Authors: M Haïssaguerre; D C Shah; P Jaïs; M Hocini; T Yamane; I Deisenhofer; M Chauvin; S Garrigue; J Clémenty Journal: Circulation Date: 2000-11-14 Impact factor: 29.690
Authors: Stephan Willems; Christian Weiss; Tim Risius; Thomas Rostock; Matthias Hoffmann; Rodolfo Ventura; Thomas Meinertz Journal: Pacing Clin Electrophysiol Date: 2003-06 Impact factor: 1.976