Randomized control trials |
Efremidis et al.[16]
|
Prosp |
161 |
Adenosine guided PVI |
80 |
80 |
54.17±10.71 |
58 (72.5) |
342±157.5 |
4.4±3.65 |
39.75±5.25 |
61.17±4.77 |
0 |
12–24 mg of adenosine after 30 min waiting period |
Documented symptomatic or asymptomatic AF episodes lasting >30 sec or documented AT after a 3-month blanking period |
50 (62.5%) |
8 (10%) |
|
|
|
Subgroup with DC and additional ablation |
26 |
|
|
|
|
|
|
|
|
|
|
12 (46.2%) |
4 (15.3%) |
|
|
|
Subgroup without DC |
54 |
|
|
|
|
|
|
|
|
|
|
38 (70.4%) |
4 (7.4%) |
|
|
|
No adenosine |
81 |
81 |
56.65±11.50 |
52 (64.2) |
341.7±149.4 |
4.59±4.26 |
38.70±4.61 |
61.67±4.95 |
0 |
N/A |
|
54 (66.7%) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Ghanbari et al.[15]
|
Prosp |
129 |
Adenosine guided PVI |
61 |
61 |
59.7±8.7 |
37 (61) |
278.6±211.9 |
NA |
41±5.3 |
59.7±5.4 |
20 (33) |
6–24 mg of adenosine for each PV and ISP at rates of 5,10,15 and 20 μg/min for 2 min at each infusion rate |
Recurrence of AF |
37 (61%) |
12 (20%) |
|
|
|
Subgroup with DC and additional ablation |
23 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Subgroup without DC |
38 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
No adenosine |
68 |
68 |
58.9±10.7 |
53 (78) |
278.6±211.9 |
N/A |
41.2±6.4 |
59.3±5.6 |
20 (29) |
ISP infusion at same rates as above |
|
45 (66%) |
9 (43%) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Kobori et al.[14]
|
Prosp |
2113 |
Adenosine guided PVI |
1112 |
737 |
58.6±8.6 |
856 (77) |
365 |
N/A |
38.9±6.3 |
64.2±7.9 |
0 |
ATP 0.4 mg/kg body weight after a median waiting period of 57 [33–87] min |
Recurrent AT lasting for 30 sec or those requiring repeat ablation, hospital admission, or usage of Vaughan Williams class I or III anti-arrhythmic drugs at 1 year with the blanking period of 90 days post-ablation |
625 (69%) |
N/A |
|
|
|
Subgroup with DC and additional ablation |
307 |
|
|
|
|
|
|
|
|
|
|
163 (64%) |
N/A |
|
|
|
Subgroup without DC |
805 |
|
|
|
|
|
|
|
|
|
|
462 (71%) |
N/A |
|
|
|
No adenosine |
1001 |
683 |
68.5±8.8 |
723 (73) |
365 |
N/A |
39.2±6.2 |
64.6±7.3 |
0 |
ISP infusion was not mandatory in the adenosine test |
|
533 (67%) |
N/A |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Macle et al.[13]
|
Prosp |
401 |
DC and additional ablation |
147 |
147 |
60.2±9.9 |
108 (74) |
368±43 |
4 (1.5–7) |
40.1±4.5 |
59.9±5.8 |
0 |
12 mg of adenosine after 20 min waiting period |
Freedom from symptomatic AF, Af, AT after a single ablation procedure between 91–365 days after the procedure |
102 (69%) |
30 (20%) |
|
|
|
DC, no further ablation |
137 |
137 |
58.4±9.7 |
97 (71) |
368±43 |
3.4 (1.7–8) |
39.6±5.9 |
60.1±7.1 |
0 |
As above |
|
58 (42%) |
48 (35%) |
|
|
|
No DC |
117 |
117 |
58.9±10.9 |
87 (74) |
368±43 |
3 (1.3–8) |
40.1±4.9 |
59.1±6.6 |
0 |
As above |
|
64 (56%) |
N/A |
|
Observational studies |
Cheung et al.[12]
|
Prosp |
152 |
DC and additional ablation |
44 |
29 |
62±9 |
34 |
374 |
NA |
40±0.6 |
60±11 |
0 |
12 mg of adenosine without waiting period |
Recurrence of AF was defined as any AT or AF recorded lasting ≥30 sec after a 3 month blanking period |
28 (64%) |
5 (11%) |
|
|
|
|
|
|
|
(77) |
(323–418) |
|
|
|
|
|
|
|
|
|
|
|
No DC |
108 |
67 |
60±11 |
86 |
374 |
NA |
43±0.7 |
59±11 |
0 |
As above |
|
82 (76%) |
13 (12%) |
|
|
|
|
|
|
|
(80) |
(323–418) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Miyazaki et al.[11]
|
Retrosp |
109 |
DC and additional ablation |
39 |
39 |
59.4±10.3 |
33 (85) |
365 |
4.7±3.6 |
39.4±5.5 |
66.4±9 |
N/A |
40 mg ATP without waiting period |
Recurrence of AF after a 1 month blanking period after ablation |
20 (51%) |
10 (26%) |
|
|
|
No DC |
70 |
70 |
61.4±11.2 |
58 (83) |
365 |
5.05±4.9 |
38.1±5.4 |
65.8±8.3 |
N/A |
|
|
51 (73%) |
22 (31%) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Matsuo et al.[9]
|
Retrosp |
233 |
DC and additional ablation |
139 |
89 |
54.±9.6 |
122 (88) |
903±394 |
4.5±4 |
38.5±5.5 |
65.9±6.6 |
N/A |
20 mg ATP after 20 min waiting period under ISP infusions at a rate of 5 up to 20 μg/min |
Maintenance of SR (no sustained AT >30 sec) without AAD during the entire follow-up period (minimum 12 months) after a 1 month blanking period after ablation |
87 (63%) |
43 (31%) |
|
|
|
No DC |
94 |
55 |
54.2±10.9 |
84 (89) |
903±394 |
4.3±3.7 |
39.7±5.7 |
65.8±7.4 |
N/A |
|
|
62 (66%) |
28 (30%) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Kumagai et al.[10]
|
Retrosp |
206 |
Adenosine guided PVI |
106 |
94 |
58±11 |
74 (70) |
480±156 |
4.5±3.9 |
39.4±5.4 |
65.1±8.9 |
N/A |
10 mg ATP during ISP infusion (5 μg/min) without waiting period |
Recurrence of AF (sustained AF lasting more than 1 min) |
81 (76%) |
11 (10%) |
|
|
|
Subgroup with DC and additional ablation |
54 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Subgroup without DC |
52 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
No adenosine |
106 |
86 |
59±10 |
83 (78) |
480±207 |
5.0±5.5 |
39.7±5.7 |
63.8±9.6 |
N/A |
ISP infusion as above |
|
66 (62%) |
10 (9%) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Hachiya et al.[8]
|
Retrosp |
252 |
Adenosine guided PVI |
82 |
62 |
56±9 |
67 (82) |
183±99 |
N/A |
41.7±6 |
N/A |
N/A |
30 mg ATP during ISP infusion (1–3 μg/min) without waiting period |
Recurrence of AF |
60 (73%) |
N/A |
|
|
|
Subgroup with DC and additional ablation |
34 |
|
|
|
|
|
|
|
|
|
|
23 (68%) |
|
|
|
|
Subgroup without DC |
48 |
|
|
|
|
|
|
|
|
|
|
37 (77%) |
|
|
|
|
No adenosine |
170 |
135 |
54±9 |
143 (84) |
183±99 |
N/A |
41.3±6 |
N/A |
N/A |
|
|
102 (60%) |
N/A |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Tritto et al.[7]
|
Prosp |
29 |
Adenosine induced PV activity |
16 |
|
|
|
|
|
|
N/A |
N/A |
12 mg of adenosine after 10 min waiting period |
Recurrence of AF |
11 (69%) |
|
|
|
|
No PV activity |
13 |
21 |
55.3±7.6 |
21 (72) |
189±72 |
5 (3–8) |
43.3±4.2 |
|
|
|
|
9 (69%) |
6 (21%) |