Early dose of Adenosine, postRadiofrequency abLation of accessory
pathwaY in determining acute procedural Success (EARLY Study)
Abstract
Introduction Post ablation of the accessory pathway (AP), the
patient is observed in the catheterization laboratory for a variable
period for resumption of pathway conduction. Aim of the study was to
determine whether the administration of intravenous adenosine at 10
minutes after ablation of accessory pathway (AP) would have the same
diagnostic accuracy as waiting for 30 minutes in predicting the
resumption of AP conduction. Methods: This was a prospective
interventional study conducted in two centers. Post ablation of the AP,
intravenous adenosine was administered at 10 minutes to look for dormant
pathway conduction. The response was recorded as positive (presence of
pathway conduction), negative (absence), or indeterminate (not able to
demonstrate AV and VA block and inability to ascertain AP conduction).
Results: The study included 110 procedures performed in 109
patients. Adenosine administration at 10 minutes showed positive result
in 3 cases (2.7%), negative result in 99 cases (90%) and indeterminate
result in 8 cases (7.3%). Reconnection of accessory pathway at 30
minutes post ablation was seen in 8 cases (7.3%). Of these 8 cases,
10minutes adenosine administration showed positive test in 3 patients
and negative test in 5 patients. Adenosine test at 10 minutes has a
sensitivity, specificity, positive predictive value, and negative
predictive value of 37.5%, 100%, 100% and 94.9% in identifying the
recurrence of accessory pathway conduction at 30 minutes, respectively.
Conclusion: Absence of pathway conduction on administration of
adenosine 10 minutes post ablation does not help predict the absence of
resumption of conduction thereafter.