Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2020, 164(2):147-153 | DOI: 10.5507/bp.2019.005

Long-term outcome of paroxysmal atrial fibrillation catheter ablation with and without pulmonary vein dormant conduction after adenosine challenge

Tomas Skalaa, Jan Preceka, Martin Hutyraa, Ondrej Moraveca, Zbynek Tudosb, Jitka Skalovac, Olga Klementovac, Andrea Antonickad, Jana Zapletalovae, Milos Taborskya
a Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
b Department of Radiology, University Hospital Olomouc, Czech Republic
c Department of Anesthesiology and Intensive Care Medicine, University Hospital Olomouc, Czech Republic
d Cardiovascular Center, Tomas Bata County Hospital, Zlin, Czech Republic
e Department of Biophysics, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic

Objectives: The prognostic significance of adenosine-mediated pulmonary vein (PV) dormant conduction is unclear. We prospectively followed patients with adenosine-mediated PV reconduction with a subsequent repeated ablation until there was no reconduction inducible with patients without reconduction after PV isolation. Method and Results. Consecutive patients (n=179) with paroxysmal atrial fibrillation (AF) without prior catheter ablation (CA) were enlisted in the study. We used a point-by-point CA and general anesthesia in all patients. Twenty minutes after PV isolation we administered adenosine in a dose sufficient to produce an atrioventricular block. If a dormant conduction was present (n=54) we performed additional ablation until there was no adenosine mediated reconduction inducible. During 36 months of follow-up, all patients were examined for eight 7-day ECG recordings. There was no difference in arrhythmia recurrence rate between patients with and without dormant conduction (29.6 vs. 24.8% at 12 months, P=0.500; 31.5 vs. 30.4% at 36 months, P=1.000), for any echocardiographic parameter or any parameter of the ablation procedure.

Conclusion: The patients with dormant conduction after adenosine during catheter ablation of paroxysmal atrial fibrillation with complete elimination of the dormant conduction by additional extensive ablation have the same outcome in the long term as patients without a dormant conduction.

Keywords: atrial fibrillation, catheter ablation, adenosine, dormant conduction, arrhythmia recurrence

Received: November 9, 2018; Accepted: February 26, 2019; Prepublished online: March 4, 2019; Published: June 18, 2020  Show citation

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Skala, T., Precek, J., Hutyra, M., Moravec, O., Tudos, Z., Skalova, J., ... Taborsky, M. (2020). Long-term outcome of paroxysmal atrial fibrillation catheter ablation with and without pulmonary vein dormant conduction after adenosine challenge. Biomedical papers, 164(2), 147-153. doi: 10.5507/bp.2019.005
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