Adenosine testing during cryoballoon ablation and radiofrequency ablation of atrial fibrillation: A propensity score–matched analysis

Dormant Conduction after Second-Generation Cryoballoon-Mediated Pulmonary Vein Isolation for Atrial Fibrillation: Comparison with Contact Force-guided Irrigated-Tip Radiofrequency Ablation

“…We reported previously that use of this module reduced the commonly reported incidence of DC which was 8~15% of initial isolated PVs 17) . The CB patients had DC in 9 PVs (4.5%) of initially isolated PVs in 9 patients (18%), which was consistent of recent reported incidences by using second-generation CB of approximately 0~4.5% of the PVs in 0-12% of patients [18][19][20] . Although cryothermal energy is a milder and safer form of energy than RF energy, cryothermal energy creates well-delineated wider lesions with preservation of tissue structure as compared to RF which causes tissue disruption from excess heating and generation of inhomogeneous lesions 21,22) .…”

“…We found a relatively higher incidence of additional ablation for residual PV potentials requiring for complete PVI (20/ [18][19][20] . The residual PV sites in the present study were observed mainly at floor of RIPV.…”

Use of adenosine to shorten the post ablation waiting period for cavotricuspid isthmus‐dependent atrial flutter

“…Initial observational studies have provided conflicting results about the prognostic significance of dormant pulmonary vein conduction revealed by adenosine, and whether such dormant conduction should be eliminated . Recent multicenter, randomized trials concluded that adenosine testing post‐PVI can identify a group that may be at higher risk of arrhythmia recurrence and might benefit from further ablation …”

Cryoballoon Ablation for Atrial Fibrillation: Double Jeopardy?

“…Other surrogate markers that may be used to judge acute procedural success that are also associated with long‐term outcome include repeat testing with adenosine to uncover dormant conduction. However, the utility of this approach is not clearly defined . The absence of truly reliable acute procedural endpoints supports the continued use of a more “maximalist” approach, understanding that the larger lesions associated with such an approach may improve efficacy but at the expense of increased collateral extracardiac effects.…”

“…However, the utility of this approach is not clearly defined. 11,12 The absence of truly reliable acute procedural endpoints supports the continued use of a more "maximalist" approach, understanding that the larger lesions associated with such an approach may improve efficacy but at the expense of increased collateral extracardiac effects. Phrenic nerve palsy remains a significant reported complication of cryoablation.…”