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Loss of Pace Capture on the Ablation Line During Pulmonary Vein Isolation versus "Dormant Conduction": Is Adenosine Expendable?

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Loss of Pace Capture on the Ablation Line During Pulmonary Vein Isolation versus "Dormant Conduction": Is Adenosine Expendable? / Schaeffer, Benjamin; Willems, Stephan; Sultan, Arian; Hoffmann, Boris A; Lüker, Jakob; Schreiber, Doreen; Akbulak, Ruken; Moser, Julia; Kuklik, Pawel; Steven, Daniel.

In: J CARDIOVASC ELECTR, Vol. 26, No. 10, 10.2015, p. 1075-1080.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Schaeffer, B, Willems, S, Sultan, A, Hoffmann, BA, Lüker, J, Schreiber, D, Akbulak, R, Moser, J, Kuklik, P & Steven, D 2015, 'Loss of Pace Capture on the Ablation Line During Pulmonary Vein Isolation versus "Dormant Conduction": Is Adenosine Expendable?', J CARDIOVASC ELECTR, vol. 26, no. 10, pp. 1075-1080. https://doi.org/10.1111/jce.12759

APA

Schaeffer, B., Willems, S., Sultan, A., Hoffmann, B. A., Lüker, J., Schreiber, D., Akbulak, R., Moser, J., Kuklik, P., & Steven, D. (2015). Loss of Pace Capture on the Ablation Line During Pulmonary Vein Isolation versus "Dormant Conduction": Is Adenosine Expendable? J CARDIOVASC ELECTR, 26(10), 1075-1080. https://doi.org/10.1111/jce.12759

Vancouver

Schaeffer B, Willems S, Sultan A, Hoffmann BA, Lüker J, Schreiber D et al. Loss of Pace Capture on the Ablation Line During Pulmonary Vein Isolation versus "Dormant Conduction": Is Adenosine Expendable? J CARDIOVASC ELECTR. 2015 Oct;26(10):1075-1080. https://doi.org/10.1111/jce.12759

Bibtex

@article{732eb3debe1c4bc19f7862e754a612f4,
title = "Loss of Pace Capture on the Ablation Line During Pulmonary Vein Isolation versus {"}Dormant Conduction{"}: Is Adenosine Expendable?",
abstract = "INTRODUCTION: Permanent pulmonary vein isolation (PVI) remains an essential goal of ablation therapy in patients with atrial fibrillation. Aim of this study was the intraindividual comparison of unexcitability to pacing along the ablation line versus dormant conduction (DC) as additional procedural endpoints.METHODS: A total of 58 patients with paroxysmal atrial fibrillation (PAF) underwent PVI by circumferential ablation of ipsilateral pulmonary veins (PVs), followed by testing for DC by adenosine administration. Irrespective of the presence of DC, pacing along the ablation line for left atrium capture was performed and additional radio frequency energy applied if necessary. PVs with initial DC were retested after achieving unexcitability.RESULTS: PVI was achieved in 224 of 224 PVs. In 33 of 224 PVs (15%) DC was revealed. At 92 of 112 ablation lines (82%) sites of excitability were found. Three (9%) of the initial 33 PVs with DC showed further DC after achieving unexcitability at repeated testing. Thirty-two of 33 assumed areas of unmasked PV-LA reconduction as revealed by DC-testing showed a corresponding site of excitability on the ablation line. After a follow-up of 11.6 ± 3.4 months 79% of patients were free of arrhythmia.CONCLUSIONS: Pacing for unexcitability can safely identify potential sites of DC and even sites that would have not been detected by testing for DC. Unexcitability, therefore, serves as a suitable and safe procedural endpoint not only for patients with contraindications to adenosine administration. Our data suggest that adenosine may be expendable when achieving unexcitability along the ablation line.",
keywords = "Adenosine, Atrial Fibrillation/diagnosis, Catheter Ablation/methods, Electrocardiography/drug effects, Female, Heart Conduction System/drug effects, Humans, Male, Middle Aged, Monitoring, Intraoperative/methods, Pulmonary Veins/drug effects, Recurrence, Treatment Outcome",
author = "Benjamin Schaeffer and Stephan Willems and Arian Sultan and Hoffmann, {Boris A} and Jakob L{\"u}ker and Doreen Schreiber and Ruken Akbulak and Julia Moser and Pawel Kuklik and Daniel Steven",
note = "{\textcopyright} 2015 Wiley Periodicals, Inc.",
year = "2015",
month = oct,
doi = "10.1111/jce.12759",
language = "English",
volume = "26",
pages = "1075--1080",
journal = "J CARDIOVASC ELECTR",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "10",

}

RIS

TY - JOUR

T1 - Loss of Pace Capture on the Ablation Line During Pulmonary Vein Isolation versus "Dormant Conduction": Is Adenosine Expendable?

AU - Schaeffer, Benjamin

AU - Willems, Stephan

AU - Sultan, Arian

AU - Hoffmann, Boris A

AU - Lüker, Jakob

AU - Schreiber, Doreen

AU - Akbulak, Ruken

AU - Moser, Julia

AU - Kuklik, Pawel

AU - Steven, Daniel

N1 - © 2015 Wiley Periodicals, Inc.

PY - 2015/10

Y1 - 2015/10

N2 - INTRODUCTION: Permanent pulmonary vein isolation (PVI) remains an essential goal of ablation therapy in patients with atrial fibrillation. Aim of this study was the intraindividual comparison of unexcitability to pacing along the ablation line versus dormant conduction (DC) as additional procedural endpoints.METHODS: A total of 58 patients with paroxysmal atrial fibrillation (PAF) underwent PVI by circumferential ablation of ipsilateral pulmonary veins (PVs), followed by testing for DC by adenosine administration. Irrespective of the presence of DC, pacing along the ablation line for left atrium capture was performed and additional radio frequency energy applied if necessary. PVs with initial DC were retested after achieving unexcitability.RESULTS: PVI was achieved in 224 of 224 PVs. In 33 of 224 PVs (15%) DC was revealed. At 92 of 112 ablation lines (82%) sites of excitability were found. Three (9%) of the initial 33 PVs with DC showed further DC after achieving unexcitability at repeated testing. Thirty-two of 33 assumed areas of unmasked PV-LA reconduction as revealed by DC-testing showed a corresponding site of excitability on the ablation line. After a follow-up of 11.6 ± 3.4 months 79% of patients were free of arrhythmia.CONCLUSIONS: Pacing for unexcitability can safely identify potential sites of DC and even sites that would have not been detected by testing for DC. Unexcitability, therefore, serves as a suitable and safe procedural endpoint not only for patients with contraindications to adenosine administration. Our data suggest that adenosine may be expendable when achieving unexcitability along the ablation line.

AB - INTRODUCTION: Permanent pulmonary vein isolation (PVI) remains an essential goal of ablation therapy in patients with atrial fibrillation. Aim of this study was the intraindividual comparison of unexcitability to pacing along the ablation line versus dormant conduction (DC) as additional procedural endpoints.METHODS: A total of 58 patients with paroxysmal atrial fibrillation (PAF) underwent PVI by circumferential ablation of ipsilateral pulmonary veins (PVs), followed by testing for DC by adenosine administration. Irrespective of the presence of DC, pacing along the ablation line for left atrium capture was performed and additional radio frequency energy applied if necessary. PVs with initial DC were retested after achieving unexcitability.RESULTS: PVI was achieved in 224 of 224 PVs. In 33 of 224 PVs (15%) DC was revealed. At 92 of 112 ablation lines (82%) sites of excitability were found. Three (9%) of the initial 33 PVs with DC showed further DC after achieving unexcitability at repeated testing. Thirty-two of 33 assumed areas of unmasked PV-LA reconduction as revealed by DC-testing showed a corresponding site of excitability on the ablation line. After a follow-up of 11.6 ± 3.4 months 79% of patients were free of arrhythmia.CONCLUSIONS: Pacing for unexcitability can safely identify potential sites of DC and even sites that would have not been detected by testing for DC. Unexcitability, therefore, serves as a suitable and safe procedural endpoint not only for patients with contraindications to adenosine administration. Our data suggest that adenosine may be expendable when achieving unexcitability along the ablation line.

KW - Adenosine

KW - Atrial Fibrillation/diagnosis

KW - Catheter Ablation/methods

KW - Electrocardiography/drug effects

KW - Female

KW - Heart Conduction System/drug effects

KW - Humans

KW - Male

KW - Middle Aged

KW - Monitoring, Intraoperative/methods

KW - Pulmonary Veins/drug effects

KW - Recurrence

KW - Treatment Outcome

U2 - 10.1111/jce.12759

DO - 10.1111/jce.12759

M3 - SCORING: Journal article

C2 - 26183341

VL - 26

SP - 1075

EP - 1080

JO - J CARDIOVASC ELECTR

JF - J CARDIOVASC ELECTR

SN - 1045-3873

IS - 10

ER -