BACKGROUND: We evaluated the effect of adenosine upon mechanisms sustaining persistent AF through analysis of contact electrograms and ECGI mapping. METHODS: Persistent AF patients undergoing catheter ablation were included. ECGI maps and cycle length (CL) measurements were recorded in the left and right atrial appendages and repeated following boluses of 18 mg of intravenous adenosine. Potential drivers (PDs) were defined as focal or rotational activations completing ≥ 1.5 revolutions. Distribution of PDs was assessed using an 18 segment biatrial model. RESULTS: 46 patients were enrolled. Mean age was 63.4 ± 9.8 years with 33 (72%) being male. There was no significant difference in the number of PDs recorded at baseline compared to adenosine (42.1 ± 15.2 vs 40.4 ± 13.0; p = 0.417), nor in the number of segments harbouring PDs, (13 (11-14) vs 12 (10-14); p = 0.169). There was a significantly higher percentage of PDs that were focal in the adenosine maps (36.2 ± 15.2 vs 32.2 ± 14.4; p < 0.001). There was a significant shortening of CL in the adenosine maps compared to baseline which was more marked in the right atrium than left atrium (176.7 ± 34.7 vs 149.9 ± 27.7 ms; p < 0.001 and 165.6 ± 31.7 vs 148.3 ± 28.4 ms; p = 0.003). CONCLUSION: Adenosine led to a small but significant shortening of CL which was more marked in the right than left atrium and may relate to shortening of refractory periods rather than an increase in driver burden or distribution. Registered on Clinicaltrials.gov: NCT03394404.
BACKGROUND: We evaluated the effect of adenosine upon mechanisms sustaining persistent AF through analysis of contact electrograms and ECGI mapping. METHODS: Persistent AFpatients undergoing catheter ablation were included. ECGI maps and cycle length (CL) measurements were recorded in the left and right atrial appendages and repeated following boluses of 18 mg of intravenous adenosine. Potential drivers (PDs) were defined as focal or rotational activations completing ≥ 1.5 revolutions. Distribution of PDs was assessed using an 18 segment biatrial model. RESULTS: 46 patients were enrolled. Mean age was 63.4 ± 9.8 years with 33 (72%) being male. There was no significant difference in the number of PDs recorded at baseline compared to adenosine (42.1 ± 15.2 vs 40.4 ± 13.0; p = 0.417), nor in the number of segments harbouring PDs, (13 (11-14) vs 12 (10-14); p = 0.169). There was a significantly higher percentage of PDs that were focal in the adenosine maps (36.2 ± 15.2 vs 32.2 ± 14.4; p < 0.001). There was a significant shortening of CL in the adenosine maps compared to baseline which was more marked in the right atrium than left atrium (176.7 ± 34.7 vs 149.9 ± 27.7 ms; p < 0.001 and 165.6 ± 31.7 vs 148.3 ± 28.4 ms; p = 0.003). CONCLUSION:Adenosine led to a small but significant shortening of CL which was more marked in the right than left atrium and may relate to shortening of refractory periods rather than an increase in driver burden or distribution. Registered on Clinicaltrials.gov: NCT03394404.
Authors: Claude S Elayi; Luigi Di Biase; Rong Bai; J David Burkhardt; Prasant Mohanty; Pasquale Santangeli; Javier Sanchez; Richard Hongo; G Joseph Gallinghouse; Rodney Horton; Shane Bailey; Salwa Beheiry; Andrea Natale Journal: J Cardiovasc Electrophysiol Date: 2013-09-10
Authors: James E Ip; Jim W Cheung; Jeffrey H Chung; Christopher F Liu; George Thomas; Steven M Markowitz; Bruce B Lerman Journal: Circ Arrhythm Electrophysiol Date: 2013-06
Authors: Jim W Cheung; James E Ip; Jeffrey H Chung; Steven M Markowitz; Christopher F Liu; George Thomas; Joseph M Lee; Seth J Lessner; Bruce B Lerman Journal: Circ Arrhythm Electrophysiol Date: 2012-06-23
Authors: Laurent Macle; Paul Khairy; Rukshen Weerasooriya; Paul Novak; Atul Verma; Stephan Willems; Thomas Arentz; Isabel Deisenhofer; George Veenhuyzen; Christophe Scavée; Pierre Jaïs; Helmut Puererfellner; Sylvie Levesque; Jason G Andrade; Lena Rivard; Peter G Guerra; Marc Dubuc; Bernard Thibault; Mario Talajic; Denis Roy; Stanley Nattel Journal: Lancet Date: 2015-07-23 Impact factor: 79.321
Authors: Jim W Cheung; Frank S Lin; James E Ip; Seth R Bender; Faisal K Siddiqi; Christopher F Liu; George Thomas; Steven M Markowitz; Bruce B Lerman Journal: Circ Arrhythm Electrophysiol Date: 2013-11-15