Ablation is used for treatment of atrial fibrillation (AF) but recurrence is common. Dormant conduction is hypothesized to be responsible for these recurrences, and the role of adenosine in identification and ablation of these pathways is controversial with conflicting results on AF recurrence.
Materials and Methods
We conducted a meta-analysis for studies evaluating AF ablation and adenosine use. Included in the meta-analysis were human studies that compared ablation using adenosine or adenosine triphosphate (ATP) and reported freedom from AF in patients beyond a minimum follow-up of 6 months.
Our analysis suggests that the use of adenosine leads to a decrease in recurrence of AF compared to the cohort which did not utilize adenosine. Subgroup analysis showed no difference in the recurrence of AF with the modality used for ablation (cryoablation vs. radiofrequency ablation) or with the preparation of adenosine used (ATP vs. adenosine). There was a significant benefit in delayed administration of ATP over early administration. Pooling results of only randomized control trials did not show any significant difference in AF recurrence.
Adenosine-guided identification and ablation of dormant pathways may lead to a decrease in recurrence of AF.
Key Indexing Terms
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Published online: October 11, 2017
Accepted: September 18, 2017
Received in revised form: September 5, 2017
Received: January 17, 2017
The authors declare no financial or other conflicts of interest.
© 2017 Southern Society for Clinical Investigation. Published by All rights reserved.