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Journal of Interventional Cardiac Electrophysiology

Published in:

01-10-2014

Adenosine testing after second-generation balloon devices (cryothermal and laser) mediated pulmonary vein ablation for atrial fibrillation

Authors: Narendra Kumar, Yuri Blaauw, Carl Timmermans, Laurent Pison, Kevin Vernooy, Harry Crijns

Published in: Journal of Interventional Cardiac Electrophysiology | Issue 1/2014

Abstract

Aims

Adenosine administration after pulmonary vein (PV) isolation using radiofrequency and cryoablation can cause acute recovery of conduction to the PVs and predicts atrial fibrillation (AF) recurrence. This study evaluated whether adenosine testing after second-generation balloon devices (cryothermal and laser) could reveal dormant PV reconduction and recurrence rate of AF.

Methods

Out of total 60 patients, 20 patients underwent PV isolation using laser balloon and for the remaining patients, the cryoballoon was used. Following PVI, waiting period of 30 min was obtained. Thereafter, a bolus 15–21 mg of adenosine was injected followed by rapid saline flush. The subsequent response was assessed for each vein using an in situ lasso catheter. Further ablation (if needed) using laser balloon and cryocatheter respectively was done, until no reconduction occurred after repeat adenosine.

Results

Acute PV isolation was achieved in all 80 PVs of 20 patients (100 %) using laser device and in 151 PVs (96.2 %) of 38 patients (95 %) using cryoballoon. However, in seven patients (35 %), 11 PVs (13.7 %) (4 LSPV, 2 LIPV, 4 RSPV, and 1 RIPV) showed dormant PV potentials after adenosine administration in laser group. Cryoballoon group showed dormant reconduction in four patients (10 %), four PVs (5 %) [one LSPV, one LIPV, and two RIPV]. The follow-up of 337 ± 92.4 days for cryoballoon and 267 ± 76.9 days for laser balloon group demonstrated similar success rates (85 %).

Conclusion

Adenosine testing after PV isolation using second-generation balloon based energy devices (laser and cryothermal) reveals dormant conduction in initially isolated PVs with similar long-term success rate.

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Title: Adenosine testing after second-generation balloon devices (cryothermal and laser) mediated pulmonary vein ablation for atrial fibrillation
Authors: Narendra Kumar
Yuri Blaauw
Carl Timmermans
Laurent Pison
Kevin Vernooy
Harry Crijns
Publication date: 01-10-2014
Publisher: Springer US
Published in: Journal of Interventional Cardiac Electrophysiology / Issue 1/2014
Print ISSN: 1383-875X
Electronic ISSN: 1572-8595
DOI: https://doi.org/10.1007/s10840-014-9921-z

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