Journal article
Use of adenosine to shorten the post ablation waiting period for cavotricuspid isthmus-dependent atrial flutter
Journal of cardiovascular electrophysiology, Vol.28(8), pp.876-881
08/2017
DOI: 10.1111/jce.13233
PMID: 28429528
Abstract
Dormant conduction unmasked by adenosine predicts clinical recurrences of cavotricuspid isthmus (CTI) dependent atrial flutter following catheter ablation. Conventional practice involves a waiting period of 20 to 30 minutes after achievement of a bidirectional line of block (BDB) to monitor for recovery of conduction.
Assess whether abolition of dormant conduction with adenosine immediately after CTI ablation and BDB can predict the lack of CTI conduction recovery during the following 30 minutes.
Consecutive patients undergoing catheter ablation for CTI-dependent atrial flutter were studied. Following the completion of CTI ablation and documentation of BDB, adenosine (≥12 mg IV) was administered immediately. In cases of dormant conduction, the CTI was ablated again until its abolition. After the achievement of BDB without dormant conduction, spontaneous CTI reconnection during the following 30 minutes and dormant conduction with adenosine at 30 minutes were evaluated.
A CTI block was achieved in 171 patients. Nine patients (5.3%) had dormant conduction across the CTI immediately after ablation and BDB, and required further ablation. Two patients (1.2%) had subsequent spontaneous time-dependent reconnection within 30 minutes. Two other patients (1.2%) developed late dormant conduction with adenosine at 30 minutes. All 4 patients underwent further ablation.
A negative adenosine challenge immediately after CTI ablation with bidirectional block, or after abolition of dormant conduction with further ablation, strongly predicted the absence of subsequent spontaneous reconnection within 30 minutes. Based on these results, the conventional waiting period is unnecessary in 97.6% patients without dormant conduction after CTI-dependent flutter ablation.
Details
- Title: Subtitle
- Use of adenosine to shorten the post ablation waiting period for cavotricuspid isthmus-dependent atrial flutter
- Creators
- Gustavo Morales - University of KentuckyYousef H Darrat - University of KentuckyNicolas Lellouche - Hôpitaux Universitaires Henri-MondorSun Moon Kim - University of KentuckyMuhammad Butt - University of KentuckyKatrina Bidwell - University of KentuckyWilliam Lippert - University of KentuckyGbolahan Ogunbayo - University of KentuckyDavid Hamon - Centre Hospitalier Universitaire Henri-MondorLuigi Di Biase - Texas Cardiac ArrhythmiaAndrea Natale - Texas Cardiac ArrhythmiaKevin Parrott - University of KentuckyClaude S Elayi - University of Kentucky
- Resource Type
- Journal article
- Publication Details
- Journal of cardiovascular electrophysiology, Vol.28(8), pp.876-881
- DOI
- 10.1111/jce.13233
- PMID
- 28429528
- ISSN
- 1045-3873
- eISSN
- 1540-8167
- Language
- English
- Date published
- 08/2017
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984691516202771
Metrics
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