Using adenosine triphosphate in catheter radiofrequency pulmonary vein isolation: does elimination of "dormant" atriovenous conduction really allow to refine long-term results?

This literature review looks at the efficacy of removing “dormant” atriovenous conduction, which can be identified by means of intravenous ejection of adenosine triphosphate following catheter isolation of pulmonary vein ostia in patients with atrial fibrillation. The incidence of detecting conduction “breakthroughs” in the ablation lines when carrying out drug tests after isolation of pulmonary veins, as well as the prognostic significance of this phenomenon for atrial fibrillation recurrence are evaluated. Also assessed are drawbacks and limitations of the studies looking at the possibility of improving the efficiency of catheter ablation of atrial fibrillation by combining the removal of “dormant” atriovenous conduction zones identified by adenosine triphosphate testing and the ablation of ganglionated plexi.