In the UNDER-ATP trial presented at the ESC Congress 2015, 2,113 patients with paroxysmal, persistent, or long-lasting atrial fibrillation were randomly assigned to receive conventional or ATP-guided pulmonary vein isolation (PVI). With ATP guidance, patients received additional radiofrequency energy applications if ATP provoked dormant pulmonary vein conduction. After 1 year, 67.1% of patients in the conventional PVI group were free from recurrent atrial tachyarrhythmia (the primary end point) compared with 68.7% of the ATP-guided PVI group (P = 0.25). ATP-guidance had no significant effect on the rate of repeat ablation, and no significant differences in these outcomes were detected according to atrial fibrillation type.
References
Kobori, A. et al. Adenosine triphosphate-guided pulmonary vein isolation for atrial fibrillation: the UNmasking Dormant Electrical Reconduction by Adenosine TriPhosphate (UNDER-ATP) trial. Eur. Heart J. 10.1093/eurheartj/ehv457
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ATP-guidance of pulmonary vein isolation does not reduce recurrence of atrial tachyarrhythmia. Nat Rev Cardiol 12, 622 (2015). https://doi.org/10.1038/nrcardio.2015.148
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DOI: https://doi.org/10.1038/nrcardio.2015.148
