The Role of Adenosine following Pulmonary Vein Isolation in Patients Undergoing Catheter Ablation for Atrial Fibrillation: A Systematic Review

McLellan, A.; Kumar, S.; Smith, Catherine L.; Morton, Joseph B.; Kalman, Jonathan M.; Kistler, P.

doi:10.1016/j.hlc.2013.05.294

Cited by 18 publications

(24 citation statements)

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“…acute adenosine/ATP-induced pulmonary vein reconnection may lead to a greater likelihood of recurrence of AF) [712][713][714][715][716][717][718].…”

Section: Atrial Fibrillationmentioning

confidence: 99%

Cardiac purinergic signalling in health and disease

Burnstock

Pelleg

2014

Purinergic Signalling

120

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This review is a historical account about purinergic signalling in the heart, for readers to see how ideas and understanding have changed as new experimental results were published. Initially, the focus is on the nervous control of the heart by ATP as a cotransmitter in sympathetic, parasympathetic, and sensory nerves, as well as in intracardiac neurons. Control of the heart by centers in the brain and vagal cardiovascular reflexes involving purines are also discussed. The actions of adenine nucleotides and nucleosides on cardiomyocytes, atrioventricular and sinoatrial nodes, cardiac fibroblasts, and coronary blood vessels are described. Cardiac release and degradation of ATP are also described. Finally, the involvement of purinergic signalling and its therapeutic potential in cardiac pathophysiology is reviewed, including acute and chronic heart failure, ischemia, infarction, arrhythmias, cardiomyopathy, syncope, hypertrophy, coronary artery disease, angina, diabetic cardiomyopathy, as well as heart transplantation and coronary bypass grafts.

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“…acute adenosine/ATP-induced pulmonary vein reconnection may lead to a greater likelihood of recurrence of AF) [712][713][714][715][716][717][718].…”

Section: Atrial Fibrillationmentioning

confidence: 99%

Cardiac purinergic signalling in health and disease

Burnstock

Pelleg

2014

Purinergic Signalling

120

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“…After achieving the PV isolation, pharmacological stimulation with adenosine and catecholamines enables wakening of dormant and partially damaged myocardial connections between the PV and LA. Subsequent ablation of these fibers can significantly increase the efficiency of the first intervention [62][63][64]. It seems that the loss of capture on the ablative line, ablation guided by atrial unipolar signal modification and development of contact-force technology could provide better transmurality, continuity and durability of ablative lesion [27,[65][66][67][68].…”

Section: Figure 2 Catheter Ablation Of Paroxysmal Af: Elimination Ofmentioning

confidence: 99%

Catheter Ablation of Lone Atrial Fibrillation

Mujović

Marinković²,

Potpara³

et al. 2014

CPD

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Atrial fibrillation is the most common sustained arrhythmia in clinical practice, associated with increased mortality, risk of stroke and heart failure, as well as the reduction of the quality of life. Atrial fibrillation may be encountered in young otherwise healthy individuals, due to the isolated electrophysiological disorder limited mostly to the pulmonary veins and posterior left atrial wall, or associated with the presence of advanced underlying heart disease and numerous cardiac and non-cardiac comorbidities with significant structural remodeling of the atrial myocardium. Due to limited efficacy and serious side effects of antiarrhythmic drugs, catheter ablation of atrial fibrillation, based on the pulmonary vein isolation for paroxysmal atrial fibrillation and adjunctive substrate modification for persistent atrial fibrillation, has emerged as an attractive and promissing alternative therapeutic option for selected patients with atrial fibrillation. In this review article, we discuss the electrophysiological left atrial abnormalities underlying lone atrial fibrillation and the role of pulmonary veins in pathophysiology of arrhythmia, and we summarize results of the studies on the long term outcome of catheter ablation of atrial fibrillation, as well as the studies on comparison of antiarrhythmic drugs with catheter ablation for treatment of atrial fibrillation. In addition, we present available data that provide better understanding of mechanisms, diagnosis, prevention and treatment of specific procedure-related complications and discuss current periprocedural anticoagulation strategies and their impact on the thromboembolic risk reduction.

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“…11 Although further ablation at these sites may improve AF-free survival, 12 paradoxically it also identifies those patients with a greater likelihood of AF recurrence despite additional ablation, possibly reflecting a higher likelihood of other incomplete lesions. 13 A unifying message from these studies is that acute electric isolation does not reliably predict permanent electric isolation.…”

Section: Article See P 1095mentioning

confidence: 99%