Adenosine Testing After Atrial Fibrillation Ablation: Systematic Review and Meta-Analysis - 28/03/18
, Steven Phan, BSc a, b, Aran Kanagaratnam, BSc a, Narendra Kumar, MD, PhD c, Kevin Phan, BSc a, bResumen |
Background |
Adenosine can be used to reveal dormant pulmonary vein (PV) conduction after pulmonary vein isolation (PVI) for the treatment of atrial fibrillation (AF). We performed a systematic review and meta-analysis to assess the impact of adenosine administration in patients undergoing PVI for AF.
Methods |
Meta-analysis of 22 studies was performed to assess the rates of freedom from AF in 1) patients with dormant PV conduction versus patients without dormant PV conduction, and 2) patients given routine adenosine post PVI versus patients not given adenosine. Relative-risks (RR) were calculated using random effects modelling.
Results |
In 18 studies, 3038 patients received adenosine and freedom from AF in those patients with dormant PV reconnection was significantly lower (62.9%) compared to patients without PV reconnection (67.2%) (RR 0.87; 95% CI: 0.78–0.98). In seven studies with 3049 patients, the freedom from AF was significantly higher in patients who received adenosine (67%) versus those patients who did not receive adenosine (63%) (RR: 1.11; 95% CI: 1.01–1.22).
Conclusions |
The present study showed clear benefits of adenosine testing for freedom from AF recurrence. Adenosine-guided dormant conduction is associated with higher AF recurrence despite further ablation. Future studies should investigate the optimal methodology, including dosage and waiting time between PVI and adenosine administration.
El texto completo de este artículo está disponible en PDF.Keywords : Adenosine, Atrial fibrillation, Ablation
Esquema
Vol 27 - N° 5
P. 601-610 - mai 2018 Regresar al número
Artículo precedente
- Balloon Aortic Valvuloplasty in the Transcatheter Valve Era: Single Centre Indications and Early Safety Data in a High Risk Population
- Thomas J. Ford, Katherine Nguyen, Joseph Brassil, Virag Kushwaha, Daniel Friedman, Roger Allan, Mark Pitney, Nigel Jepson
- Early Invasive Versus Initially Conservative Strategy in Elderly Patients Older Than 75 Years with Non-ST-Elevation Acute Coronary Syndrome: A Meta-Analysis
- Wenfang Ma, Yan Liang, Jun Zhu
Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción.
¿Ya suscrito a @@106933@@ revista ?