Introduction: Adenosine administration after PVI using radiofrequency and cryo ablation reveal acute recovery of the conduction to the PVs and predict AF recurrence. It is considered superior to isoproteronolol. This study aimed to determine whether adenosine can reveal dormant PV sleeves after using EAS.
Methods: All AADs were stopped 5 days before the procedure except for patients on Amiodarone. All 11 patients underwent PVI using EAS (CardioFocus Inc., Marlborough, MA, USA). After waiting for 30 minutes, other ablation lesions (Table 1) and sinus rhythm were obtained; bolus of adenosine 15-21 mg was injected followed by rapid saline flush. The subsequent response was assessed for each vein using an in-situ lasso catheter. Further ablation (if needed) using EAS was done till no reconduction occurred with repeat adenosine.
Results: Acute PV isolation was achieved in all 41 PVs in 11 patients. In 4 patients,6 PVs (2 LSPV, 1 LIPV, 2 RSPV, 1 RIPV) showed dormant PV potentials.
Conclusions: Adenosine testing after pulmonary vein isolation using EAS reveals dormant conduction in initially isolated PVs. This testing may improve success rates when EAS is used.