Adenosine usage during AF ablation in Europe and selected long-term findings from the ESC-EHRA EORP Atrial Fibrillation Ablation Long-Term registry

Frank van Rosmalen, Tammo Delhaas, Nikolaos Dagres, Elena Arbelo, Carina Blomstrom-Lundqvist, Harry J. G. M. Crijns, Antoine Da Costa, Mariusz Pytkowski, Nikita Sharikov, Cecile Laroche, Luigi Tavazzi, Joseph Brugada, Laurent Pison*, ESC-EHRA Atrial Fibrillation Ablation Long-Term Registry investigators

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Web of Science)


Background Adenosine can be used to reveal dormant pulmonary vein (PV) conduction after PV isolation (PVI). This study presents a subanalysis of real-world 1-year follow-up data from the ESC-EHRA EORP Atrial Fibrillation (AF) Ablation Long-Term registry to analyze the usage of adenosine during PVI treatment in terms of rhythm outcome and safety. Methods The registry consists of 104 participating centers in 27 countries within the European Society of Cardiology. The registry data was split into an adenosine group (AG) and no-adenosine group (NAG). Procedure characteristics and patient outcome were compared. Results Adenosine was administered in 10.8% of the 3591 PVI patients included in the registry. Spain, the Netherlands, and Italy included the majority of adenosine cases (48.8%). Adenosine was applied more often in combination with open irrigation radiofrequency (RF) energy (74.7%) and less often in combination with nonirrigated RF energy (1.6%). After 1 year, a higher percentage of the AG was free from AF compared with the NAG (68.9% vs 59.1%, p <0.001). Adenosine was associated with better rhythm outcome in RF ablation procedures, but not in cryo-ablation procedures (freedom from AF: RF: AG: 70.9%, NAG: 58.1%, p <0.001, cryo: AG: 63.9%, NAG: 63.8%, p = 0.991). Conclusions The use of adenosine was associated with a better rhythm outcome after 1 year follow-up and seems more useful in patients treated with RF energy compared with patients treated with cryo energy. Given the improved rhythm outcome at 1-year follow-up, it seems reasonable to encourage the use of adenosine during RF AF ablation.

Original languageEnglish
Pages (from-to)395-406
Number of pages12
JournalJournal of Interventional Cardiac Electrophysiology
Issue number3
Early online date30 Apr 2020
Publication statusPublished - Apr 2021


  • Adenosine
  • Pulmonary vein isolation
  • Rhythm outcome
  • Safety
  • Follow-up

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