Abstract 16235: Association Between Adenosine-Induced Pulmonary Vein Ectopy and Dormant Conduction Following Pulmonary Vein Isolation
Background: We have recently shown that adenosine (ADO) can induce PV ectopy in electrically silent PVs following PV isolation, possibly via induction of autonomic triggers. The implications of ADO-induced PV ectopy for dormant conduction following PV isolation are unclear. We sought to examine whether ADO-induced PV ectopy is associated with ADO-induced PV reconnection.
Methods: A total of 107 pts (84 M; mean age 60 ± 10 yrs) undergoing PV isolation for AF were studied. After each PV was isolated, any spontaneous dissociated PV ectopy was noted. ADO (12 mg IV bolus) was then given and any ADO-induced PV reconnection was noted. In addition, for PVs that were electrically silent prior to ADO administration, the presence of ADO-induced PV ectopy was identified.
Results: After isolation of 398 PVs, spontaneous dissociated ectopy was identified in 81 (20%) PVs. These PVs had a non-significant trend towards higher rates of ADO-induced reconnection when compared to PVs without dissociated ectopy (29% vs. 19%; p = 0.09). Among the 317 electrically silent PVs following isolation, ADO induced transient PV ectopy in 51 (16%) veins. PVs with ADO-induced ectopy had significantly higher rates of dormant conduction when compared to PVs without ADO-induced ectopy (31% vs. 12%; p = 0.003). Of the 11 PVs with both ADO-induced ectopy and ADO-induced PV reconnection, 6 (55%) PVs exhibited dormant exit conduction.
Conclusions: Adenosine-induced PV ectopy following PV isolation is associated with a higher incidence of dormant conduction. The presence of exit conduction of PV ectopy following ADO administration provides evidence that dormant conduction can be bidirectional.
- © 2012 by American Heart Association, Inc.