{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T20:27:10Z","timestamp":1776198430248,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,5,23]],"date-time":"2013-05-23T00:00:00Z","timestamp":1369267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>Adenosine Unmasking Dormant Conduction Across the Cavotricuspid Isthmus<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Adenosine\u2010induced hyperpolarization may identify pulmonary veins at risk of reconnection following electrical isolation for atrial fibrillation. The potential role of adenosine testing in other arrhythmic substrates, such as cavotricuspid isthmus (CTI)\u2010dependent atrial flutter, remains unclear. We assessed whether dormant conduction across the CTI may be revealed by adenosine after ablation\u2010induced bidirectional block, and its association with recurrent flutter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Patients undergoing catheter ablation for CTI\u2010dependent flutter were prospectively studied. After confirming bidirectional block across the CTI by standard pacing maneuvers, adenosine (\u226512 mg IV) was administered to assess resumption of conduction, followed by isoproterenol (ISP) bolus. Further CTI ablation was performed for persistent (but not transient) resumption of conduction.<\/jats:p><jats:p>Bidirectional block across the CTI was achieved in all 81 patients (63 males), age 61.2 \u00b1 11.0 years. The trans\u2010CTI time increased from 71.9 \u00b1 18.1 milliseconds preablation to 166.2 \u00b1 26.4 milliseconds postablation. Adenosine elicited resumption of conduction across the CTI in 7 patients (8.6%), 2 of whom had transient recovery. No additional patient with dormant conduction was identified by ISP. Over a follow\u2010up of 11.8 \u00b1 8.0 months, atrial flutter recurred in 4 (4.9%) patients, 3\/7(42.9%) with a positive adenosine challenge versus 1\/74 (1.3%) with a negative response, P = 0.0016 (relative risk 31.7).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Adenosine challenge following atrial flutter ablation provoked transient or persistent resumption of conduction across the CTI in almost 9% of patients and identified a subgroup at higher risk of flutter recurrence. It remains to be determined whether additional ablation guided by adenosine testing during the index procedure may further improve procedural outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.12174","type":"journal-article","created":{"date-parts":[[2013,5,3]],"date-time":"2013-05-03T08:42:14Z","timestamp":1367570534000},"page":"995-1001","source":"Crossref","is-referenced-by-count":16,"title":["Adenosine Testing in Atrial Flutter Ablation: Unmasking of Dormant Conduction Across the Cavotricuspid Isthmus and Risk of Recurrence"],"prefix":"10.1111","volume":"24","author":[{"given":"GUSTAVO X.","family":"MORALES","sequence":"first","affiliation":[{"name":"University of Kentucky  Lexington Kentucky"},{"name":"Lexington VA Medical Center  Lexington Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LAURENT","family":"MACLE","sequence":"additional","affiliation":[{"name":"Montreal Heart Institute and Universit\u00e9 de Montr\u00e9al  Quebec 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