| ObjectiveThe effects of adenosine or adenosine triphosphate(ATP)test on recovered left atrium-pulmonary veins conduction after cumferential pulmonary vein isolation(CPVI)for atrial fibrillation(AF)have been widely studied.Whereas,few reports have focus on adenosine triphosphate test for provoking reconduction after cryoballoon pulmonary vein isolation.The present study aimed to evaluate the influence of ATP on induced pulmonary veins reconduction and to access the prognosis after cryoballoon.MethodsA total of seventy-eight patients [47 males,32 females;average age(56.4±9.3)years] with AF were enrolled.from January 2015 and September 2015 in this study.All of the patients underwent cryoballoon ablation were divided into 2 groups.After cryoablation and a wating period of 30 minutes,ATP was injected to the patients in ATP test group in order to induce pulmonary vein conduction recovery while ATP was not injected to the patients in control group.If pulmonary vein conduction was recoverable and continued,cyroablation was carried out to reach pulmonary vein isolation again in both groups.Recurrence of AF in two groups were compared at 3 and 9.9±2.0 months.ResultsThere were no significant differences in sex,age,body weight,paroxysmal AF / persistent AF,the number of pulmonary veins,type of cryoballoon,duration of cryoablation,temperature of cryoablation,times of cryoablation,incidence of vagal reactions,the prevalence of coronary heart disease,hypertension prevalence,diabetes prevalence,prevalence of brain infarction,left ventricular ejection fraction(LVEF),left atrial anterior and posterior diameter(LA value)and left ventricle end-diastolic dimension(LVDD value).between ATP test group and control group.In the ATP test group,8 patients(17.4%)pulmonary vein conduction recovery and 8 of 184(4.3%)pulmonary vein potential recovery were observed after ATP-injection.In the control group,1 patient(3.3%)"spontaneous " pulmonary vein conduction recovery and 2 of 133(1.5%)pulmonary vein potential recovery were observed in 30 minutes after cryoablation.During 3 and 9.9±2.0 months of follow-up period,there were respectively 13 patients(28.3%)and 12 patients(26.1%)in the ATP test group who suffered from the recurrence of AF at 3 and 9.9±2.0 months.In the control group,there were 14 patients(42.4%)and 13 patients(39.4%)having recurrence at 3 and 9.9±2.0 months.The percentage of pulmonary veins recovery in the ATP test group was much higher than that in the control group,while there was no statistical difference(P=0.11).The recurrence rate of AF in the control group was also much lower than that in the ATP test group during 3 months and 9.9±2.0 months follow-up.There were no statistical differences(P>0.05).Among 8 patients who had pulmonary vein conduction recovery after ATP-injection in the experimental group,3 patients(37.5%)suffered from the recurrence of AF during a follow-up period of 3 months,and 2 patients(25.0%)suffered from the recurrence of AF during a follow-up period of 9.9±2.0 months.Among 38 patients who were observed no pulmonary vein conduction recovery after ATP-injection in the ATP test group,10 patients(26.3%)suffered from a recurrence of AF during a follow-up period of 3 months,while,10 patients(26.3%)suffered from a recurrence of AF during a follow-up period of 9.9±2.0 months.There was no statistical difference between two groups(P>0.05).There weren’t enough cases for statistical analysis in the control group.Conclusions 1.ATP test may improve the recurrence rate of left atrium-pulmonary veins after cryoballoon ablation.2.A transient pulmonary veins reconnection may lead to recurrence of AF.3.There was no statistical difference of the recurrence of AF between ATP test group and control group.However,there was remarkable difference of the recurrence of AF(26.1% VS 39.4%).A multi-centers,large-sample clinical research was needed to access the role of ATP test on the recurrence of AF. |
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