Adenosine-induced atrial fibrillation after pulmonary vein isolation was not associated with a difference in AF recurrence compared to patients without AIAF (16.7% vs. 18.6%, p=0.827).
Cohort (n=616)
Does the presence of adenosine-induced atrial fibrillation after PVI predict recurrence, and does additional ablation of trigger sites improve outcomes in patients with paroxysmal AF?
Adenosine-induced atrial fibrillation after PVI is not associated with increased AF recurrence, and additional ablation of trigger sites does not appear to improve clinical outcomes.
Tasa de eventos absoluta: 16.7% vs 18.6%
valor p: p=0.827
Background: Adenosine can cause dormant electrical conduction between the pulmonary vein and left atrium after pulmonary vein isolation (PVI). Adenosine can also induce atrial fibrillation (AF) during catheter ablation. However, the clinical outcomes and effects of additional ablation for the trigger sites of adenosine-induced AF (AIAF) are unknown. This study therefore aimed to evaluate the clinical significance of AIAF. Methods: Between January 2010 and September 2019, we analyzed 616 consecutive patients with paroxysmal AF (PAF) who underwent radiofrequency catheter ablation (RFCA), including wide-area circumferential pulmonary vein isolation (PVI) and post-PVI adenosine testing. Results: Among 616 patients, 134 (21.7%) and 34 (5.5%) showed dormant conduction and AIAF, respectively. Eight patients (1.3%) had both dormant conduction and AIAF. The AF recurrence rate was not significantly different between patients with and without AIAF (16.7% vs. 18.6%, log-rank p = 0.827) during a mean follow-up period of 17.9 ± 18 months. Additional RFCA for the trigger site was attempted in 10 patients with AIAF; however, the recurrence rate of atrial arrhythmias was also not different between the groups with and without additional ablation (20% vs. 16.7%, log-rank p = 0.704). Conclusions: AIAF after PVI was not clinically associated with recurrence during long-term follow-up. Ablation of the trigger site in AIAF did not improve the clinical outcomes.
Choi et al. (Mon,) conducted a cohort in Paroxysmal atrial fibrillation (n=616). Adenosine-induced atrial fibrillation (AIAF) vs. No AIAF was evaluated on Atrial fibrillation recurrence (p=0.827). Adenosine-induced atrial fibrillation after pulmonary vein isolation was not associated with a difference in AF recurrence compared to patients without AIAF (16.7% vs. 18.6%, p=0.827).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: