Adenosine triphosphate-guided pulmonary vein isolation for atrial fibrillation: the UNmasking Dormant Electrical Reconduction by Adenosine TriPhosphate (UNDER-ATP) trial

European Heart Journal
Atsushi KoboriUNDER-ATP Trial Investigators

Abstract

Most of recurrent atrial tachyarrhythmias after pulmonary vein isolation (PVI) for atrial fibrillation (AF) are due to reconnection of PVs. The aim of the present study was to evaluate whether elimination of adenosine triphosphate (ATP)-induced dormant PV conduction by additional energy applications during the first ablation procedure could reduce the incidence of recurrent atrial tachyarrhythmias. We randomly assigned 2113 patients with paroxysmal, persistent, or long-lasting AF to either ATP-guided PVI (1112 patients) or conventional PVI (1001 patients). The primary endpoint was recurrent atrial tachyarrhythmias lasting for >30 s or those requiring repeat ablation, hospital admission, or usage of Vaughan Williams class I or III antiarrhythmic drugs at 1 year with the blanking period of 90 days post ablation. Among patients assigned to ATP-guided PVI, 0.4 mg/kg body weight of ATP provoked dormant PV conduction in 307 patients (27.6%). Additional radiofrequency energy applications successfully eliminated dormant conduction in 302 patients (98.4%). At 1 year, 68.7% of patients in the ATP-guided PVI group and 67.1% of patients in the conventional PVI group were free from the primary endpoint, with no significant difference (adjus...Continue Reading

References

Sep 3, 1998·The New England Journal of Medicine·M HaïssaguerreJ Clémenty
Sep 15, 2004·Journal of Cardiovascular Electrophysiology·Thomas ArentzMichel Haissaguerre
May 18, 2007·Journal of Cardiovascular Electrophysiology·Seiichiro MatsuoSeibu Mochizuki
Dec 10, 2009·Circulation. Arrhythmia and Electrophysiology·Riccardo CappatoElia Biganzoli
Jan 27, 2015·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Jean-Benoît le Polain de WarouxChristophe Scavee

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Citations

Mar 17, 2016·Cardiology Research and Practice·Paolo D DallaglioKim Rajappan
Jan 5, 2016·European Heart Journal·Jan SteffelGerhard Hindricks
Dec 9, 2015·European Heart Journal·Thomas F Lüscher
May 26, 2016·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Kazuki IsoAtsushi Hirayama
Aug 28, 2016·European Heart Journal·Paulus KirchhofUNKNOWN ESC Scientific Document Group
Nov 4, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Paulus KirchhofKatja Zeppenfeld
Sep 25, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Paulus KirchhofKatja Zeppenfeld
Mar 13, 2017·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Mindy VroomenLaurent Pison
Mar 5, 2019·Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia·Tomas SkalaMilos Taborsky
Jan 5, 2016·Nature Reviews. Cardiology·Laurent Macle, Stanley Nattel
Dec 4, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Atul Verma, Andrea Chiocchini
Jun 18, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Nobuaki TanakaSatoshi Shizuta
Nov 13, 2019·Herzschrittmachertherapie & Elektrophysiologie·Clemens Jilek, Thorsten Lewalter
Jul 21, 2020·Arrhythmia & Electrophysiology Review·Gareth Dk Matthews, Andrew A Grace
Apr 22, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Yi-He ChenYi-Gang Li

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