Objective： To evaluate the incidence and clinical outcome of adenosine triphosphate（ATP） plus isoproterenol（ISP）-induced non-pulmonary vein（PV） foci before and after circumferential PV isolation（CPVI） during ...Objective： To evaluate the incidence and clinical outcome of adenosine triphosphate（ATP） plus isoproterenol（ISP）-induced non-pulmonary vein（PV） foci before and after circumferential PV isolation（CPVI） during index ablation in patients with paroxysmal atrial fibrillation（PAF）. Methods： In 80 consecutive patients undergoing catheter ablation for drug-refractory, symptomatic PAF at our hospital from April 2010 to January 2011, atrial fibrillation（AF） was provoked with ATP（20 mg） and ISP（20 μg/min） administration before and after CPVI. The spontaneous initiation of AF was mapped and recorded. Results： Before ablation, AF mostly originating from PVs（PV vs. non-PV, 36/70 vs. 3/70; P〈0.01） was induced in 39 patients with sinus rhythm. CPVI significantly suppressed AF inducibility; however, more non-PV foci were provoked（post-CPVI vs. pre-CPVI, 13/76 vs. 3/70; P=0.016）. Patients with pre- and post-CPVI induced AF（n=49） were divided according to non-PV foci being induced（group N, n=17） or not（group P, n=32）. After mean（19.2±8.2） months follow-up, 88.2%（15/17） and 65.6%（21/32） of patients in groups N and P, respectively, were free from AF recurrence（P=0.088）. Conclusions： ATP＋ISP administration effectively provokes non-PV foci, especially after CPVI in PAF patients. Although in this study difference did not achieve statistical significance, supplementary ablation targeting non-PV foci might benefit clinical outcome.展开更多
文摘Objective： To evaluate the incidence and clinical outcome of adenosine triphosphate（ATP） plus isoproterenol（ISP）-induced non-pulmonary vein（PV） foci before and after circumferential PV isolation（CPVI） during index ablation in patients with paroxysmal atrial fibrillation（PAF）. Methods： In 80 consecutive patients undergoing catheter ablation for drug-refractory, symptomatic PAF at our hospital from April 2010 to January 2011, atrial fibrillation（AF） was provoked with ATP（20 mg） and ISP（20 μg/min） administration before and after CPVI. The spontaneous initiation of AF was mapped and recorded. Results： Before ablation, AF mostly originating from PVs（PV vs. non-PV, 36/70 vs. 3/70; P〈0.01） was induced in 39 patients with sinus rhythm. CPVI significantly suppressed AF inducibility; however, more non-PV foci were provoked（post-CPVI vs. pre-CPVI, 13/76 vs. 3/70; P=0.016）. Patients with pre- and post-CPVI induced AF（n=49） were divided according to non-PV foci being induced（group N, n=17） or not（group P, n=32）. After mean（19.2±8.2） months follow-up, 88.2%（15/17） and 65.6%（21/32） of patients in groups N and P, respectively, were free from AF recurrence（P=0.088）. Conclusions： ATP＋ISP administration effectively provokes non-PV foci, especially after CPVI in PAF patients. Although in this study difference did not achieve statistical significance, supplementary ablation targeting non-PV foci might benefit clinical outcome.
