Usefulness of the Adenosine Triphosphate with a Sufficient Observation Period for Detecting Reconduction after Pulmonary Vein Isolation

作者：Ninomiya Yuichi; Iriki Yasuhisa; Ishida Sanemasa^*; Oketani Naoya; Matsushita Takehiko; Ichiki Hitoshi; Okui Hideki; Kataoka Tetsuro; Yoshikawa Akiko; Ogawa Masakazu; Saihara Keishi; Shinsato Takuro; Miyata Masaaki; Hamasaki Shuichi; Tei Chuwa

来源：Pacing and Clinical Electrophysiology, 2009, 32(10): 1307-1312.

DOI：10.1111/j.1540-8159.2009.02478.x

• adenosine triphosphate
• atrial fibrillation
• observation period
• pulmonary vein isolation
• reconduction

Methods: In 21 patients (18 males, 56 +/- 11 years) with drug refractory AF, radiofrequency circumferential PV antrum ablation was performed in all 4 PVs. After the completion of isolation, electrograms in each PV were repeatedly recorded (1.98 +/- 0.57 times per PV) using a circular mapping catheter for an observation period of 87 +/- 29 minutes. After isolation of all 4 PVs, 30 mg of adenosine triphosphate (ATP) was administered during isoproterenol infusion.
Results: PV electrical isolation was initially achieved in all 81 PVs. During the observation period, 12 (15%) PVs in 10 (48%) of 21 patients exhibited spontaneous reconduction. Among the remaining 69 PVs, 8 (12%) additional PVs had reconduction with the use of ATP. All PV reconduction was successfully eliminated by 4.5 +/- 2.2 additional radiofrequency applications.
Conclusion: A sufficient observation period and the use of ATP are useful to detect early reconduction after PV isolation.
(PACE 2009; 1307-1312).

• 出版日期2009-10