Administration of Adenosine Triphosphate Provides Additional Value Over Programmed Electrophysiologic Study in Confirmation of Successful Ablation of Atrioventricular Accessory Pathways

Objectives: To study the benefit of adenosine triphosphate (ATP) in evaluating ablation endpoints of accessory pathways (AP) and subsequent long-term prognosis.Methods: We reviewed consecutive patients with supraventricular tachycardias due to APs that underwent radiofrequency catheter ablation (RFC...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Wei Wei, Xianhong Fang, Michael Shehata, Xunzhang Wang, Xianzhang Zhan, Hai Deng, Hongtao Liao, Zili Liao, Yang Liu, Yumei Xue, Shulin Wu
Formato: article
Lenguaje:EN
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://doaj.org/article/b65885668c874096845882cf33076562
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:b65885668c874096845882cf33076562
record_format dspace
spelling oai:doaj.org-article:b65885668c874096845882cf330765622021-11-16T05:47:01ZAdministration of Adenosine Triphosphate Provides Additional Value Over Programmed Electrophysiologic Study in Confirmation of Successful Ablation of Atrioventricular Accessory Pathways2297-055X10.3389/fcvm.2021.716400https://doaj.org/article/b65885668c874096845882cf330765622021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.716400/fullhttps://doaj.org/toc/2297-055XObjectives: To study the benefit of adenosine triphosphate (ATP) in evaluating ablation endpoints of accessory pathways (AP) and subsequent long-term prognosis.Methods: We reviewed consecutive patients with supraventricular tachycardias due to APs that underwent radiofrequency catheter ablation (RFCA) from January 2016 to September 2018 in our center. The patients were divided into two groups: the ATP group (who had passed both the ATP test and PES after ablation as the endpoint) and the non-ATP group (who had passed PES only after ablation as the endpoint). We reviewed the patients' intra-cardiac electrograms and analyzed their long-term outcomes.Results: In total, 1,343 patients underwent successful RFCA. There were 215 patients in the ATP group with one lost to follow-up. There were 1,128 patients in the non-ATP group with 39 lost to follow-up. Twenty-three patients in the ATP group demonstrated additional electrophysiological entities due to ATP administration, including reappearance of the ablated APs in 16 patients, discovery of PES-undetected APs in 5, induction of atrial fibrillation in 5, premature atrial contractions in 1, and premature ventricular contractions in another. During the 7 to 39 months (average 24.4 ± 9.5 months) follow-up, the recurrence rate was 8.41% (18/214) in the ATP group and 6.80% (74/1,084) in the non-ATP group. In subjects with recurrence, 14 patients (14/18 = 77.8%) in the ATP group and 50 patients (50/74 = 67.6%) in the non-ATP group accepted redo ablations. Among the ATP-group, all the 14 redo APs were the old ones as before. Among the non-ATP-group, redo ablations confirmed that 39 APs were the old ones, while 20 APs were newly detected ones which had been missed previously. The difference in recurrent AP locations confirmed by redo procedures between the two groups was significant (p = 0.008). In the non-ATP group, 20 (40%) of redo cases were proven to have multiple APs, while 33 (3.3%) cases who did not suffer from recurrence had multiple APs. Existences of multiple APs in recurred cases were significantly higher than that in non-recurred ones in the non-ATP group (p < 0.001), while there was no such difference in the ATP group (p = 0.114).Conclusions: The existence of multiple APs was more common in recurrent cases if ATP was not used for confirmation of ablation endpoints. ATP probably has additional value over PES alone by detecting weak AP conductions. ATP can evoke atrial and ventricular arrhythmias.Wei WeiWei WeiXianhong FangXianhong FangMichael ShehataXunzhang WangXunzhang WangXianzhang ZhanXianzhang ZhanHai DengHai DengHongtao LiaoHongtao LiaoZili LiaoZili LiaoYang LiuYang LiuYumei XueYumei XueShulin WuShulin WuFrontiers Media S.A.articleadenosine triphosphateprogrammed electrophysiologic studycatheter ablationaccessory pathwayslong-term outcomesDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution DOAJ
collection DOAJ
language EN
topic adenosine triphosphate
programmed electrophysiologic study
catheter ablation
accessory pathways
long-term outcomes
Diseases of the circulatory (Cardiovascular) system
RC666-701
spellingShingle adenosine triphosphate
programmed electrophysiologic study
catheter ablation
accessory pathways
long-term outcomes
Diseases of the circulatory (Cardiovascular) system
RC666-701
Wei Wei
Wei Wei
Xianhong Fang
Xianhong Fang
Michael Shehata
Xunzhang Wang
Xunzhang Wang
Xianzhang Zhan
Xianzhang Zhan
Hai Deng
Hai Deng
Hongtao Liao
Hongtao Liao
Zili Liao
Zili Liao
Yang Liu
Yang Liu
Yumei Xue
Yumei Xue
Shulin Wu
Shulin Wu
Administration of Adenosine Triphosphate Provides Additional Value Over Programmed Electrophysiologic Study in Confirmation of Successful Ablation of Atrioventricular Accessory Pathways
description Objectives: To study the benefit of adenosine triphosphate (ATP) in evaluating ablation endpoints of accessory pathways (AP) and subsequent long-term prognosis.Methods: We reviewed consecutive patients with supraventricular tachycardias due to APs that underwent radiofrequency catheter ablation (RFCA) from January 2016 to September 2018 in our center. The patients were divided into two groups: the ATP group (who had passed both the ATP test and PES after ablation as the endpoint) and the non-ATP group (who had passed PES only after ablation as the endpoint). We reviewed the patients' intra-cardiac electrograms and analyzed their long-term outcomes.Results: In total, 1,343 patients underwent successful RFCA. There were 215 patients in the ATP group with one lost to follow-up. There were 1,128 patients in the non-ATP group with 39 lost to follow-up. Twenty-three patients in the ATP group demonstrated additional electrophysiological entities due to ATP administration, including reappearance of the ablated APs in 16 patients, discovery of PES-undetected APs in 5, induction of atrial fibrillation in 5, premature atrial contractions in 1, and premature ventricular contractions in another. During the 7 to 39 months (average 24.4 ± 9.5 months) follow-up, the recurrence rate was 8.41% (18/214) in the ATP group and 6.80% (74/1,084) in the non-ATP group. In subjects with recurrence, 14 patients (14/18 = 77.8%) in the ATP group and 50 patients (50/74 = 67.6%) in the non-ATP group accepted redo ablations. Among the ATP-group, all the 14 redo APs were the old ones as before. Among the non-ATP-group, redo ablations confirmed that 39 APs were the old ones, while 20 APs were newly detected ones which had been missed previously. The difference in recurrent AP locations confirmed by redo procedures between the two groups was significant (p = 0.008). In the non-ATP group, 20 (40%) of redo cases were proven to have multiple APs, while 33 (3.3%) cases who did not suffer from recurrence had multiple APs. Existences of multiple APs in recurred cases were significantly higher than that in non-recurred ones in the non-ATP group (p < 0.001), while there was no such difference in the ATP group (p = 0.114).Conclusions: The existence of multiple APs was more common in recurrent cases if ATP was not used for confirmation of ablation endpoints. ATP probably has additional value over PES alone by detecting weak AP conductions. ATP can evoke atrial and ventricular arrhythmias.
format article
author Wei Wei
Wei Wei
Xianhong Fang
Xianhong Fang
Michael Shehata
Xunzhang Wang
Xunzhang Wang
Xianzhang Zhan
Xianzhang Zhan
Hai Deng
Hai Deng
Hongtao Liao
Hongtao Liao
Zili Liao
Zili Liao
Yang Liu
Yang Liu
Yumei Xue
Yumei Xue
Shulin Wu
Shulin Wu
author_facet Wei Wei
Wei Wei
Xianhong Fang
Xianhong Fang
Michael Shehata
Xunzhang Wang
Xunzhang Wang
Xianzhang Zhan
Xianzhang Zhan
Hai Deng
Hai Deng
Hongtao Liao
Hongtao Liao
Zili Liao
Zili Liao
Yang Liu
Yang Liu
Yumei Xue
Yumei Xue
Shulin Wu
Shulin Wu
author_sort Wei Wei
title Administration of Adenosine Triphosphate Provides Additional Value Over Programmed Electrophysiologic Study in Confirmation of Successful Ablation of Atrioventricular Accessory Pathways
title_short Administration of Adenosine Triphosphate Provides Additional Value Over Programmed Electrophysiologic Study in Confirmation of Successful Ablation of Atrioventricular Accessory Pathways
title_full Administration of Adenosine Triphosphate Provides Additional Value Over Programmed Electrophysiologic Study in Confirmation of Successful Ablation of Atrioventricular Accessory Pathways
title_fullStr Administration of Adenosine Triphosphate Provides Additional Value Over Programmed Electrophysiologic Study in Confirmation of Successful Ablation of Atrioventricular Accessory Pathways
title_full_unstemmed Administration of Adenosine Triphosphate Provides Additional Value Over Programmed Electrophysiologic Study in Confirmation of Successful Ablation of Atrioventricular Accessory Pathways
title_sort administration of adenosine triphosphate provides additional value over programmed electrophysiologic study in confirmation of successful ablation of atrioventricular accessory pathways
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/b65885668c874096845882cf33076562
work_keys_str_mv AT weiwei administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT weiwei administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT xianhongfang administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT xianhongfang administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT michaelshehata administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT xunzhangwang administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT xunzhangwang administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT xianzhangzhan administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT xianzhangzhan administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT haideng administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT haideng administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT hongtaoliao administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT hongtaoliao administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT zililiao administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT zililiao administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT yangliu administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT yangliu administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT yumeixue administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT yumeixue administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT shulinwu administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
AT shulinwu administrationofadenosinetriphosphateprovidesadditionalvalueoverprogrammedelectrophysiologicstudyinconfirmationofsuccessfulablationofatrioventricularaccessorypathways
_version_ 1718426688905281536