Document Detail


Late re-conduction sites in the second session after pulmonary vein isolation using adenosine provocation for atrial fibrillation.
MedLine Citation:
PMID:  24128812     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Intravenous adenosine triphosphate (ATP) administration could reveal dormant conduction (DC) gaps on the ablation line of a pulmonary vein isolation (PVI). We compared the ATP-provoked DC sites in the initial PVI with the PV re-conduction sites in the second session in patients with paroxysmal atrial fibrillation (AF).METHODS AND RESULTS: We conducted a multicenter, observational study from a prospective registry undergoing AF ablation. A total of 110 consecutive drug-refractory paroxysmal AF patients were enroled in this study. Dormant conduction was detected by an ATP provocation of up to 40 mg during a continuous isoproterenol infusion (0.5-2 μg/min). The DC sites at each of the right and left PVs were precisely determined by using double spiral catheters under the guidance of a three-dimensional constructed anatomical mapping system. In the initial session, DC was observed in 35 patients (31.8%, 1.3 gaps/patient), and the sites of the DC were commonly observed in the carina region (43.5%). Atrial fibrillation recurrence was confirmed in 33 patients (30.0%) during follow-up (27.1 months), and a second session was performed in 24 of 33 patients (70.6%). In the second session, the re-conduction sites were also commonly observed in the carina region (59.5%).CONCLUSION: The carina region was still a dominant re-conduction site even after the elimination of any ATP-provoked DC in the index procedure.
Authors:
Kazuaki Kaitani; Toshiya Kurotobi; Atsushi Kobori; Katsunori Okajima; Takenori Yao; Yuko Nakazawa; Yoshihisa Nakagawa
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-14
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  -     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Cardiovascular Medicine, Tenri Hospital, 200 Mishima, Tenri, Nara 632-8552, Japan.
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