Universität zu Köln

Schaeffer, Benjamin, Willems, Stephan, Sultan, Arian, Hoffmann, Boris A., Lueker, Jakob, Schreiber, Doreen, Akbulak, Ruken, Moser, Julia, Kuklik, Pawel ORCID: 0000-0001-8440-654X and Steven, Daniel (2015). Loss of Pace Capture on the Ablation Line During Pulmonary Vein Isolation versus Dormant Conduction: Is Adenosine Expendable? J. Cardiovasc. Electrophysiol., 26 (10). S. 1075 - 1081. HOBOKEN: WILEY-BLACKWELL. ISSN 1540-8167

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Abstract

Loss of Pace Capture and Dormant Conduction in PVI IntroductionPermanent 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. MethodsA 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. ResultsPVI 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. ConclusionsPacing 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schaeffer, Benjamin UNSPECIFIED UNSPECIFIED UNSPECIFIED Willems, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Sultan, Arian UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoffmann, Boris A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lueker, Jakob UNSPECIFIED UNSPECIFIED UNSPECIFIED Schreiber, Doreen UNSPECIFIED UNSPECIFIED UNSPECIFIED Akbulak, Ruken UNSPECIFIED UNSPECIFIED UNSPECIFIED Moser, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuklik, Pawel UNSPECIFIED orcid.org/0000-0001-8440-654X UNSPECIFIED Steven, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-391170
DOI:	10.1111/jce.12759
Journal or Publication Title:	J. Cardiovasc. Electrophysiol.
Volume:	26
Number:	10
Page Range:	S. 1075 - 1081
Date:	2015
Publisher:	WILEY-BLACKWELL
Place of Publication:	HOBOKEN
ISSN:	1540-8167
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PAROXYSMAL ATRIAL-FIBRILLATION; LONG-TERM FREEDOM; CONTACT FORCE; CATHETER ABLATION; FOLLOW-UP; RECONNECTIONS; RATIONALE; TRIAL Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39117