Introduction
Catheter ablation is a definitive therapy for supraventricular
tachycardia that involves an accessory pathway (AP). The acute success
rate of catheter ablation is around 90-95% with a recurrence rate of
5-10%.1-3 The resumption of accessory pathway
conduction within 24 hours is defined as early
recurrence.4-6 After ablation of the AP, the patient
is observed for resumption of pathway conduction in the catheterization
laboratory. This observation period is variable, and most centers have
done so for a minimum of 30 minutes after successful radiofrequency
application.7
Adenosine is a natural nucleoside with a short half-life, used for
unmasking latent preexcitation.8,9 It is given after
catheter ablation to unmask dormant AP conduction by slowing
atrioventricular conduction and causing membrane
hyperpolarization.10,11 Timing of adenosine
administration post-ablation varies in different studies from 15 to 30
minutes.10,12 We hypothesized that administration of
intravenous adenosine at 10 minutes after ablation would have the same
diagnostic accuracy as waiting for 30 minutes in predicting a resumption
of AP conduction. The waiting period and the total procedure time could
be abbreviated if this was true.