B-PO03-106 ASSOCIATION BETWEEN ADENOSINE USE AND ATRIAL FIBRILLATION RECURRENCE AFTER PULMONARY VEIN ISOLATION USING HIGH POWER SHORT DURATION ABLATION IN PATIENTS WITH ATRIAL FIBRILLATION

Abstract

There is conflicting literature with regards to the effectiveness of adenosine in assessing PVI and long-term outcomes. Effectiveness of adenosine in the setting of HPSD is unknown. To study the association between adenosine use to assess pulmonary vein isolation (PVI) and long-term outcomes in patients who underwent atrial fibrillation (AF) ablation using high power short duration (HPSD) radiofrequency ablation technique. In this retrospective cohort analysis, case records of 215 consecutive patients with paroxysmal AF who underwent ablation at Wake Forest University, Baptist hospital between January 2018 - May 2020 were assessed. Five operators performed all the ablations using HPSD technique (50 watts RF lesions applied 5-8 secs in the posterior wall and 10 secs in the anterior wall). All study patients uniformly received PVI. Further, 81% (174/215 patients) received adenosine to assess PV reconnection and 19% (41/215 patients) did not receive adenosine to assess PV reconnection. Adenosine administration was per the discretion of the operator. Of the 215 study patients, 140/215 patients (65%) were men. Mean age was 66 years. At 1year follow-up, 14/41 (34%) had recurrence of AF in the no-adenosine group, whereas 53/174 (30%) had recurrence in the adenosine group (P = 0.65). Adenosine use to assess PV reconnection had similar odds of AF recurrence at 1-year follow-up [(unadjusted OR: 0.85, 95% CI: 0.41 - 1.74, P = 0.65), (fully adjusted OR: 0.82, 95% CI: 0.40 - 1.73, P = 0.61)]. Adenosine use to assess PV reconnection did not decrease AF recurrence at 1-year follow-up in patients undergoing PVI using HPSD technique. Larger sample randomized investigations are needed to confirm our findings.