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Europace Advance Access published online on October 31, 2009
Europace, doi:10.1093/europace/eup339
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

CLINICAL RESEARCH

Transient atriovenous reconnection induced by adenosine after successful pulmonary vein isolation with the cryothermal energy balloon

Gian Battista Chierchia1,* {dagger}, Yoshinao Yazaki1 {dagger}, Antonio Sorgente1, Lucio Capulzini1, Carlo de Asmundis1, Andrea Sarkozy1, Matthias Duytschaever2, Roberto De Ponti3 and Pedro Brugada1

1 Heart Rhythm Management Centre, UZ Brussel-VUB, Laarbeeklaan 101, 1090 Brussels, Belgium; 2 Department of Cardiology, Sint Jans Hospitaal, Brugge, Belgium; 3 Department of Heart Sciences, Ospedale di Circolo and Fondazione Macchi, Varese, University of Insubria, Varese, Italy

Aims: Cryothermal energy balloon ablation (CBA), using cryogenic ablative energy, has proven very effective in producing pulmonary vein (PV) isolation in patients with paroxysmal atrial fibrillation (AF). Adenosine testing after PV isolation has demonstrated to be able to unmask incomplete lesion after radiofrequency (RF) ablation. The aim of our study was to assess the rate of transient atriovenous reconnection induced by adenosine after successful PV isolation with the CBA in a group of patients with paroxysmal AF.

Methods and results: We prospectively enrolled 39 patients (31 male; age 59 ± 11 years) elected to circumferential PV isolation with CBA for highly symptomatic paroxysmal AF. A total of 149 PVs were evidenced. Adenosine testing after CBA induced a left atrium–PV reconnection only in 7 (4.6%) of PV.

Conclusion: Our study showed a low rate of transient PV reconnection after adenosine infusion following successful PV isolation with CBA. However, larger studies will be needed in order to confirm our findings and the prognostic value of adenosine testing after successful PV isolation obtained with CBA.

Key Words: Ablation, Atrial fibrillation, Adenosine, Cryoballoon

* Corresponding author. Tel: +32 2 4763038, Fax: +32 2 477 6840, Email: gbchier{at}yahoo.it

{dagger} The first two authors contributed equally to the study.

Manuscript submitted 27 July 2009. Accepted after revision 10 March 2009.


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