Key result
Adenosine testing identifies the earliest atrial potential to terminate atrial tachycardia during pulmonary vein fibrillation.
Case Report (n=1)
Adenosine testing can successfully identify the exit site of dormant conduction during confined pulmonary vein tachycardia, enabling targeted ablation to terminate recurrent atrial tachycardia.
May allow targeted ablation of dormant conduction in recurrent atrial tachycardia; hypothesis-generating from one case and needs prospective validation.
Identifying earliest pulmonary vein (PV) potential (entrance site) during adenosine-exposed reconnection is required to eliminate dormant conduction after PV isolation. However, it i's impossible during confined PV fibrillation/tachycardia (PVT). A 56-year-old man underwent repeat ablation procedure. Following PV re-isolation, confined ipsilateral left PVT was observed (Panel A). Adenosine provoked clinical recurrent atrial tachycardia (AT) following the adenosine-exposed reconnection (Panel B). The earliest atrial potential (exit site) was finally identified on the circumferential ablation line during the exposed reconnection, and AT was immediately terminated at the site despite persistent PVT. This case highlights how to identify the dormant conduction during confined PVT. Conflict of interest: none declared.
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Miyazaki et al. (2013) conducted a case report in Confined pulmonary vein fibrillation/tachycardia (n=1). Adenosine test and targeted ablation was evaluated on Identification of dormant conduction and termination of atrial tachycardia. Adenosine testing successfully identified the earliest atrial potential on the circumferential ablation line during confined pulmonary vein fibrillation, allowing immediate termination of atrial tachycardia.
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