Adenosine testing and reablation of dormant potentials after second-generation cryoballoon ablation increased the clinical success rate for atrial fibrillation to 84% vs 79% without testing.
Cohort (n=90)
Does adenosine testing and reablation of dormant potentials after second-generation cryoballoon ablation improve the clinical success rate for atrial fibrillation?
Adenosine testing to identify and re-ablate dormant conduction after second-generation cryoballoon ablation may improve freedom from atrial fibrillation recurrence.
Absolute Event Rate: 84% vs 79%
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.
Kumar et al. (Tue,) conducted a cohort in Atrial fibrillation (n=90). Adenosine testing and reablation of dormant potentials vs. No adenosine testing was evaluated on Clinical success rate for atrial fibrillation. Adenosine testing and reablation of dormant potentials after second-generation cryoballoon ablation increased the clinical success rate for atrial fibrillation to 84% vs 79% without testing.