Adenosine Triphosphate Exposes Dormant Pulmonary Vein Conduction Responsible for Recurrent Atrial Tachyarrhythmias

Importance of Evaluating the Dormant Conduction During the Re-Do Ablation Procedure

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A 61-year-old man suffered from atrial tachycardia (AT) following pulmonary vein isolation (PVI) treatment of atrial fibrillation. During a re-do procedure, all pulmonary veins (PVs) were isolated from the left atrium (LA) and programmed stimulation could not induce any atrial arrhythmias. Adenosine triphosphate exposed dormant PV-LA conduction at the right superior PV. PV firing during the reconnection caused AT with the same P-wave morphology as clinical AT. For 6 months after the elimination of that dormant PV conduction, the patient has been free of any AT. Evaluation of dormant PV conduction was effective in curing the recurrent AT after PVI. (Circ J 2009; 73: 1160-1162)