ELIMINATION OF DORMANT PULMONARY VEIN CONDUCTION REVEALED BY ADENOSINE AFTER THEIR INITIAL ISOLATION: RANDOMIZED 3-YEAR FOLLOW-UP STUDY
E. Lyan, A. Klukvin, G. Gromyko, F. Tursunova, A. Kazakov, A. Morozov, A. Merkureva, P. Krasnoperov, S. Yashin
Cardiac Electrophysiology Department, Pavlov State Medical University, Saint Petersburg, Russia
Introduction: Study was aimed to evaluate whether additional dormant conduction ablation improves clinical outcomes in patients with atrial fibrillation after pulmonary vein (PV) isolation.
Methods: Study included 134 patients with paroxysmal and persistent atrial fibrillation. After PV isolation, 30 minutes observation period was applied, followed by adenosine-test. In case of dormant conduction patients were randomized to 2 groups. Dormant conduction was eliminated by additional ablations in all patients of ATP-Abl group and remained intact in ATP-Control group.
Results: Adenosine-test revealed dormant conduction in 33 out of 268 ipsilateral PV pairs (12%) in 31 patients (23%). ATP-Abl group included 14 patients, in whom dormant conduction were eliminated by additional ablations in 15 ipsilateral PV pairs. ATP-Control group included 17 patients, in whom dormant conduction was revealed in 18 ipsilateral PV pairs and left intacted. After 40 months follow-up 6 patients in ATP-Abl group (43%) and 6 patients in ATP-Control group (35%) were free from any arrhythmia, difference didn’t demonstrate statistical significance (Log Rank = 0,75; p=0,39).
Conclusions: Elimination of dormant PV conduction does not improve long-term clinical outcomes after PV isolation.
