Transient atriovenous reconnection induced by adenosine after successful pulmonary vein isolation with the cryothermal energy balloon

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Abstract
Cryothermal energy balloon ablation (CBA), using cryogenic ablative energy, has proven very effective in producing pulmonary vein (PV) isolation in patients with paroxysmal atrial fibrillation (AF). Adenosine testing after PV isolation has demonstrated to be able to unmask incomplete lesion after radiofrequency (RF) ablation. The aim of our study was to assess the rate of transient atriovenous reconnection induced by adenosine after successful PV isolation with the CBA in a group of patients with paroxysmal AF. We prospectively enrolled 39 patients (31 male; age 59 ± 11 years) elected to circumferential PV isolation with CBA for highly symptomatic paroxysmal AF. A total of 149 PVs were evidenced. Adenosine testing after CBA induced a left atrium–PV reconnection only in 7 (4.6%) of PV. Our study showed a low rate of transient PV reconnection after adenosine infusion following successful PV isolation with CBA. However, larger studies will be needed in order to confirm our findings and the prognostic value of adenosine testing after successful PV isolation obtained with CBA.

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