What question did this study set out to answer?

To evaluate the relationship between ATP-induced dormant pulmonary veins and the pulmonary vein carina region following circumferential pulmonary vein electrical isolation.

December 15, 2009Journal of Cardiovascular Electrophysiology

ATP‐Induced Dormant Pulmonary Veins Originating from the Carina Region After Circumferential Pulmonary Vein Isolation of Atrial Fibrillation

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Why the study?

Does ATP injection to identify and ablate dormant pulmonary veins reduce atrial fibrillation recurrence in symptomatic AF patients undergoing CPVEI?

Population

212 consecutive symptomatic atrial fibrillation patients undergoing circumferential pulmonary vein…

Comparison

ATP injection during an intravenous… vs No ATP injection after CPVEI (n=106).

Design

Cohort

Follow-up

16 +/- 6.1 months

Authors

KKKoji KumagaiElectrophysiology SNShigeto NaitoGunma Prefectural Cardiovascular Center KNKoki NakamuraTokyo University of Science

Discussion

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Implication

ATP-guided ablation was associated with lower AF recurrence; leaves open efficacy in randomized CPVEI trials.

Key Points

To evaluate the relationship between ATP-induced dormant pulmonary veins and the pulmonary vein carina region following circumferential pulmonary vein electrical isolation.
Retrospective review of 212 consecutive patients with symptomatic atrial fibrillation undergoing circumferential pulmonary vein electrical isolation (CPVEI) with a double lasso technique.
Patients were divided into Group 1 (n = 106), who received an intravenous ATP challenge during isoproterenol infusion post-CPVEI, and Group 2 (n = 106), who did not receive ATP.
Radiofrequency energy was applied to the earliest dormant activation sites along the CPVEI line, targeting the carina region if initial ablation proved ineffective, with follow-up over 16 ± 6.1 months.
In Group 1, 51% (54/106) exhibited dormant pulmonary vein reconnections during ATP challenge, with dormant veins reisolated at the carina in 23% of right PVs and 26% of left PVs.
The anatomical distribution of dormant PV reconnection sites differed significantly from acute isolation sites, except in the right inferior pulmonary vein (P < 0.05).
Atrial fibrillation recurred significantly more often in Group 2 compared to Group 1 over 16 ± 6.1 months of follow-up (P < 0.05).

Structured PICO

Does ATP injection to identify and ablate dormant pulmonary veins reduce atrial fibrillation recurrence in symptomatic AF patients undergoing CPVEI?

Population

212 consecutive symptomatic atrial fibrillation (AF) patients undergoing circumferential pulmonary vein electrical isolation (CPVEI) with a double lasso technique.

Intervention

ATP injection during an intravenous isoproterenol infusion after CPVEI to identify and ablate dormant pulmonary veins (n=106).

Comparator

No ATP injection after CPVEI (n=106).

Outcome

Atrial fibrillation recurrence during follow-up.

ATP injection after CPVEI to identify and ablate dormant pulmonary veins, particularly at the carina region, significantly reduces atrial fibrillation recurrence.

Cite This Study

Kumagai et al. (2009) studied this question.

synapsesocial.com/papers/6a73dbc7f7f3d6603e0dd4eb https://doi.org/10.1111/j.1540-8167.2009.01667.x

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes Anticoagulation in AF

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ATP‐Induced Dormant Pulmonary Veins Originating from the Carina Region After Circumferential Pulmonary Vein Isolation of Atrial Fibrillation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

ATP‐Induced Dormant Pulmonary Veins Originating from the Carina Region After Circumferential Pulmonary Vein Isolation of Atrial Fibrillation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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