Identification and Ablation of Dormant Conduction in Atrial Fibrillation Using Adenosine

Faraz Khan Luni, Abdur Rahman Khan, Hemindermeet Singh, Haris Riaz, Sonia Ali Malik, Owais Khawaja, Talha Farid, Jennifer Cummings, Mohammed Taleb

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Ablation is used for treatment of atrial fibrillation (AF) but recurrence is common. Dormant conduction is hypothesized to be responsible for these recurrences, and the role of adenosine in identification and ablation of these pathways is controversial with conflicting results on AF recurrence. Materials and Methods: We conducted a meta-analysis for studies evaluating AF ablation and adenosine use. Included in the meta-analysis were human studies that compared ablation using adenosine or adenosine triphosphate (ATP) and reported freedom from AF in patients beyond a minimum follow-up of 6 months. Results: Our analysis suggests that the use of adenosine leads to a decrease in recurrence of AF compared to the cohort which did not utilize adenosine. Subgroup analysis showed no difference in the recurrence of AF with the modality used for ablation (cryoablation vs. radiofrequency ablation) or with the preparation of adenosine used (ATP vs. adenosine). There was a significant benefit in delayed administration of ATP over early administration. Pooling results of only randomized control trials did not show any significant difference in AF recurrence. Conclusions: Adenosine-guided identification and ablation of dormant pathways may lead to a decrease in recurrence of AF.

Original languageEnglish (US)
Pages (from-to)27-36
Number of pages10
JournalAmerican Journal of the Medical Sciences
Volume355
Issue number1
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

Keywords

  • Ablation
  • Adenosine
  • Arrhythmias
  • Atrial fibrillation
  • Electrophysiology

ASJC Scopus subject areas

  • Medicine(all)

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