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Adenosine Sensitivity is Associated with Ablation Success Rate and Recurrence Rate with Nonirrigated Catheters in Patients with Ventricular Premature Contractions/Tachycardia from the Ventricular Outflow Tract

摘要Background:A high ablation success rate for ventricular arrhythmia (VA) from outflow tract has been achieved,but some of them cannot be eliminated from endocardium.We investigated the association between adenosine sensitivity and ablation success/recurrence rates with a nonirrigated or an irrigated catheter.Methods:According to adenosine test,all patients were divided into a sensitive group (S group) or an insensitive group (Ⅰ group).The patients of each group were randomized into a nonirrigated catheter (NA) subgroup or an irrigated catheter (IA) subgroup with a 2∶1 ratio.Results:In S group of 122 patients (84 in NA subgroup),the ablation success rate was similar between two subgroups (94.7% vs.90.5%,P > 0.05),but in Ⅰ group of 94 patients (60 in NA subgroup),it was higher in IA subgroup (94.1%) than that in NA subgroup (73.3%,P < 0.05).The success rate using nonirrigated catheter was significantly higher in S group (90.5%) than that in Ⅰ group (73.3%,P < 0.01),and the recurrence rate was lower in S group than that in Ⅰ group (1.3%,vs.13.6%,P < 0.05).On the contrary,the success rate and the recurrence rate using irrigated catheter were similar between S group and 1 group (94.7%,94.1%,P > 0.05,vs.2.8%,6.3%,P > 0.05).Conclusions:Adenosine insensitivity is associated with a lower success rate and a higher recurrence rate for VA patients undergoing nonirrigated catheter ablation.Thus,irrigated catheters should be the first choice for VA ablation in adenosine insensitive patients.

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作者单位 Department of Cardiology, Xinhua Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200092, China [1] Metropolitan Heart and Vascular Institute, Minneapolis, MN., USA [2]
栏目名称 Original Articles
DOI 10.4103/0366-6999.149184
发布时间 2015-02-13
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中华医学杂志(英文版)

中华医学杂志(英文版)

2015年128卷2期

147-152页

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