Use of adenosine to identify patients at risk for recurrence of accessory pathway conduction after initially successful radiofrequency catheter ablation

K. W. Walker, M. J. Silka, Daniel (Dan) Haupt, Jack Kron, J. H. McAnulty, B. D. Halperin

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objectives: The use of adenosine after radiofrequency catheter ablution of accessory pathways was prospectively studied to determine its utility for identifying patients at risk for recurrence of accessory pathway conduction and to guide therapy that might reduce late recurrence in this group. Background: Accessory pathway conduction recurs in 5%-12% of patients following initially 'successful' radiofrequency catheter ablation. Adenosine may facilitate conduction over accessory pathways that have been modified by radiofrequency delivery, thus identifying patients at risk for recurrence. Methods: Radiofrequency catheter ablution was performed in 109 patients. Prior to ablution, 12-18 mg of adenosine was administered. After ablution, when all evidence of accessory pathway conduction remained absent for at least 30 minutes, adenosine 12-18 mg was again administered. Results: Adenosine given prior to radiofrequency catheter ablution did not block accessory pathway conduction in any patient. Adenosine given after elimination of accessory pathway conduction induced complete atrioventricular and ventriculoatrial block in 95 patients; 11 (11.6%) subsequently had recurrence of accessory path way function. Accessory path way conduction was unmasked by adenosine in 12 patients (11.2%). After further deliveries of radiofrequency energy, 7 of these 12 patients subsequently demonstrated adenosine induced atrioventricular and ventriculoatrial block; 1 of these 7 patients experienced recurrence of accessory path way conduction. The remaining 5 patients demonstrated persistent accessory pathway conduction only with adenosine; all experienced clinical recurrence of accessory pathway function. Conclusion: The use of adenosine after presumed successful radiofrequency catheter ablation may reveal persistent accessory pathway conduction. Elimination of this latent accessory pathway conduction reduces the risk for recurrence.

Original languageEnglish (US)
Pages (from-to)441-446
Number of pages6
JournalPACE - Pacing and Clinical Electrophysiology
Volume18
Issue number3 I
StatePublished - 1995

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Catheter Ablation
Adenosine
Recurrence
Catheters
Atrioventricular Block

Keywords

  • adenosine
  • catheter ablation
  • Wolff-Parkinson-White syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Use of adenosine to identify patients at risk for recurrence of accessory pathway conduction after initially successful radiofrequency catheter ablation. / Walker, K. W.; Silka, M. J.; Haupt, Daniel (Dan); Kron, Jack; McAnulty, J. H.; Halperin, B. D.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 18, No. 3 I, 1995, p. 441-446.

Research output: Contribution to journalArticle

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abstract = "Objectives: The use of adenosine after radiofrequency catheter ablution of accessory pathways was prospectively studied to determine its utility for identifying patients at risk for recurrence of accessory pathway conduction and to guide therapy that might reduce late recurrence in this group. Background: Accessory pathway conduction recurs in 5{\%}-12{\%} of patients following initially 'successful' radiofrequency catheter ablation. Adenosine may facilitate conduction over accessory pathways that have been modified by radiofrequency delivery, thus identifying patients at risk for recurrence. Methods: Radiofrequency catheter ablution was performed in 109 patients. Prior to ablution, 12-18 mg of adenosine was administered. After ablution, when all evidence of accessory pathway conduction remained absent for at least 30 minutes, adenosine 12-18 mg was again administered. Results: Adenosine given prior to radiofrequency catheter ablution did not block accessory pathway conduction in any patient. Adenosine given after elimination of accessory pathway conduction induced complete atrioventricular and ventriculoatrial block in 95 patients; 11 (11.6{\%}) subsequently had recurrence of accessory path way function. Accessory path way conduction was unmasked by adenosine in 12 patients (11.2{\%}). After further deliveries of radiofrequency energy, 7 of these 12 patients subsequently demonstrated adenosine induced atrioventricular and ventriculoatrial block; 1 of these 7 patients experienced recurrence of accessory path way conduction. The remaining 5 patients demonstrated persistent accessory pathway conduction only with adenosine; all experienced clinical recurrence of accessory pathway function. Conclusion: The use of adenosine after presumed successful radiofrequency catheter ablation may reveal persistent accessory pathway conduction. Elimination of this latent accessory pathway conduction reduces the risk for recurrence.",
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T1 - Use of adenosine to identify patients at risk for recurrence of accessory pathway conduction after initially successful radiofrequency catheter ablation

AU - Walker, K. W.

AU - Silka, M. J.

AU - Haupt, Daniel (Dan)

AU - Kron, Jack

AU - McAnulty, J. H.

AU - Halperin, B. D.

PY - 1995

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N2 - Objectives: The use of adenosine after radiofrequency catheter ablution of accessory pathways was prospectively studied to determine its utility for identifying patients at risk for recurrence of accessory pathway conduction and to guide therapy that might reduce late recurrence in this group. Background: Accessory pathway conduction recurs in 5%-12% of patients following initially 'successful' radiofrequency catheter ablation. Adenosine may facilitate conduction over accessory pathways that have been modified by radiofrequency delivery, thus identifying patients at risk for recurrence. Methods: Radiofrequency catheter ablution was performed in 109 patients. Prior to ablution, 12-18 mg of adenosine was administered. After ablution, when all evidence of accessory pathway conduction remained absent for at least 30 minutes, adenosine 12-18 mg was again administered. Results: Adenosine given prior to radiofrequency catheter ablution did not block accessory pathway conduction in any patient. Adenosine given after elimination of accessory pathway conduction induced complete atrioventricular and ventriculoatrial block in 95 patients; 11 (11.6%) subsequently had recurrence of accessory path way function. Accessory path way conduction was unmasked by adenosine in 12 patients (11.2%). After further deliveries of radiofrequency energy, 7 of these 12 patients subsequently demonstrated adenosine induced atrioventricular and ventriculoatrial block; 1 of these 7 patients experienced recurrence of accessory path way conduction. The remaining 5 patients demonstrated persistent accessory pathway conduction only with adenosine; all experienced clinical recurrence of accessory pathway function. Conclusion: The use of adenosine after presumed successful radiofrequency catheter ablation may reveal persistent accessory pathway conduction. Elimination of this latent accessory pathway conduction reduces the risk for recurrence.

AB - Objectives: The use of adenosine after radiofrequency catheter ablution of accessory pathways was prospectively studied to determine its utility for identifying patients at risk for recurrence of accessory pathway conduction and to guide therapy that might reduce late recurrence in this group. Background: Accessory pathway conduction recurs in 5%-12% of patients following initially 'successful' radiofrequency catheter ablation. Adenosine may facilitate conduction over accessory pathways that have been modified by radiofrequency delivery, thus identifying patients at risk for recurrence. Methods: Radiofrequency catheter ablution was performed in 109 patients. Prior to ablution, 12-18 mg of adenosine was administered. After ablution, when all evidence of accessory pathway conduction remained absent for at least 30 minutes, adenosine 12-18 mg was again administered. Results: Adenosine given prior to radiofrequency catheter ablution did not block accessory pathway conduction in any patient. Adenosine given after elimination of accessory pathway conduction induced complete atrioventricular and ventriculoatrial block in 95 patients; 11 (11.6%) subsequently had recurrence of accessory path way function. Accessory path way conduction was unmasked by adenosine in 12 patients (11.2%). After further deliveries of radiofrequency energy, 7 of these 12 patients subsequently demonstrated adenosine induced atrioventricular and ventriculoatrial block; 1 of these 7 patients experienced recurrence of accessory path way conduction. The remaining 5 patients demonstrated persistent accessory pathway conduction only with adenosine; all experienced clinical recurrence of accessory pathway function. Conclusion: The use of adenosine after presumed successful radiofrequency catheter ablation may reveal persistent accessory pathway conduction. Elimination of this latent accessory pathway conduction reduces the risk for recurrence.

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