Abstract 14079: Additional Dipyridamole Effect in Adenosine-Induced Transient Reconnection after Pulmonary Vein Isolation
Introduction: Transient reconnection (dormant conduction) of the isolated pulmonary vein (PV) is induced by administration of adenosine triphosphate (ATP). Recent reports suggested that elimination of these dormant PV conductions by additional radiofrequency (RF) applications could reduce the recurrence after PV isolation. However, the elimination of dormant conduction is sometimes challenging due to its short time duration. We hypothesized that dipyridamole, which is phosphodiesterase inhibitor increasing adenosine levels, can augment dormant conduction and contribute the elimination of dormant conduction, resulting reduce the AF recurrence.
Methods: 120 drug-refractory symptomatic paroxysmal AF patients (91 men, aged 62 ± 11 years) underwent circumferential PV isolation. In 87 of 120 (73%) patients, solely ATP (20mg) was administered after PV isolation (ATP group). The additional dipyridamole (0.16mg/kg) injection following ATP (20mg) was administered in 33 of 120 (27%) patients (DP+ATP group). Additional RF deliveries were applied for dormant conduction after PVI.
Results: Dormant conduction was observed in 34 patients (29%) of ATP group and in 20 (17%) of DP+ATP group (P=0.043). Mean duration of transient dormant conduction was significantly longer in DP+ATP compare to ATP (15.9±8.9 vs 63.7±50.4 sec; p < 0.001). The elimination of dormant conduction was achieved in 12 of 26 (46%) patients in ATP group and 8 of 19 (42%) in DP+ATP group (NS). The recurrence was observed in 10 patients (29%) of ATP group and in 8 (40%) of DP+ATP group during 8.9±3.9 month follow-up after 1st PV isolation (NS).
Conclusion: Additional dipyridamole administration significantly augmented frequency and duration of ATP-induced dormant conduction after PV isolation but RF deliveries for ATP-induced dormant conduction could not contribute the reduction of the recurrence of AF after PV isolation.
- © 2012 by American Heart Association, Inc.