Adenosine-Provoked Atrial Fibrillation Originating From Non-Pulmonary Vein Foci: The Clinical Significance and Outcome After Catheter Ablation

JACC. Clinical Electrophysiology
Akio KuroiYoshito Iesaka

Abstract

The goal of this study was to systematically investigate the incidence and clinical significance of non-pulmonary vein (PV) foci revealed by adenosine/adenosine triphosphate (ATP) testing during atrial fibrillation (AF) ablation. ATP is reported to provoke AF. A total of 464 patients with consecutive paroxysmal AF undergoing ATP testing after PV antrum isolation were included. AF originating from non-PV foci was provoked in 26 (5.6%) total patients during first (n = 20) or repeat (n = 8) ablation procedures. Dormant PV conduction was also revealed by ATP testing in 6 patients. Non-PV foci were located in the superior vena cava (SVC) (i.e., the SVC group) and atria (i.e., the atria group) in 10 and 18 (9 each in the right and left atria) patients, respectively. In the multivariable analysis, being female was the sole independent predictor of ATP-provoked AF originating from non-PV foci (hazard ratio [HR]: 2.52 [95% confidence interval (CI): 1.069 to 5.929]; p = 0.034). After additional ablation targeting non-PV foci, freedom from recurrent AF after the last procedure was similar between the SVC group and patients without ATP-provoked AF but was significantly lower in the atria group than in others (p = 0.0008). Atria group membe...Continue Reading

References

May 1, 1991·Circulation·B B Lerman, L Belardinelli
May 1, 1991·Circulation·I BiaggioniD Robertson
Sep 1, 1994·Cardiovascular Research·G KabellL Belardinelli
Aug 14, 2003·Pacing and Clinical Electrophysiology : PACE·Dipen ShahMeleze Hocini
Sep 15, 2004·Journal of Cardiovascular Electrophysiology·Thomas ArentzMichel Haissaguerre
Jun 7, 2005·Journal of the American College of Cardiology·Benjamin J ScherlagWarren M Jackman
Dec 22, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Dimpi PatelAndrea Natale
Mar 25, 2010·European Heart Journal·Isabelle NaultMichel Haïssaguerre
Jan 6, 2012·The Canadian Journal of Cardiology·Laurent MacleUNKNOWN ADVICE Study Investigators
Aug 22, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Heiko LehrmannAmir Jadidi
May 21, 2013·Circulation. Arrhythmia and Electrophysiology·Shinsuke MiyazakiYoshito Iesaka
Jun 21, 2013·International Journal of Cardiology·Masateru TakigawaMitsuaki Isobe
Aug 9, 2013·Circulation Journal : Official Journal of the Japanese Circulation Society·Takashi UchiyamaYoshito Iesaka
Dec 11, 2013·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Susumu TaoMitsuaki Isobe
Sep 23, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Takamitsu TakagiYoshito Iesaka

❮ Previous
Next ❯

Citations

May 11, 2016·Circulation. Arrhythmia and Electrophysiology·Saurabh Kumar, Gregory F Michaud
Aug 30, 2019·Arrhythmia & Electrophysiology Review·Nicolas JohnerDipen C Shah
Dec 28, 2018·Arrhythmia & Electrophysiology Review·Satoshi HigaShih-Ann Chen
Mar 24, 2021·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Shinsuke MiyazakiHiroshi Tada
Dec 4, 2021·Current Opinion in Cardiology·Shinsuke Miyazaki

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiac Conduction System

The cardiac conduction system is a specialized tract of myocardial cells responsible for maintaining normal cardiac rhythm. Discover the latest research on the cardiac conduction system here.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.