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Updated: May 4, 2026

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Published on: January 31, 2019

Adenosine mapping for adenosine-dependent accessory pathway ablation.

Martin J Lapage¹, Michael J Walsh, John H Reed

¹Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan.

Pacing and Clinical Electrophysiology : PACE

|December 31, 2013

Summary

This summary is machine-generated.

Adenosine administration can activate dormant accessory pathways (APs) during ablation procedures, enabling successful mapping and treatment. However, residual AP conduction activated by adenosine predicts supraventricular tachycardia recurrence.

Keywords:

accessory pathway adenosine mapping

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Area of Science:

Electrophysiology
Cardiology

Background:

Accessory pathways (APs) can be inactive during electrophysiology studies.
Adenosine can be used to unmask these dormant APs.

Purpose of the Study:

To evaluate the efficacy of adenosine administration for mapping and ablating adenosine-dependent accessory pathways.
To assess the predictability of recurrence based on adenosine-induced conduction.

Main Methods:

Retrospective review of patients undergoing AP ablation (1998-2008).
Adenosine boluses were administered to activate APs for mapping.
Analysis of acute ablation outcomes and long-term follow-up.

Main Results:

Adenosine mapping was used in seven patients with inactive or intermittent AP conduction.
Four patients had complete AP elimination, two had adenosine-dependent conduction, and one had recurrence.
Residual AP conduction, particularly in the superior septal region, was associated with recurrence.

Conclusions:

Adenosine mapping is effective for ablating adenosine-dependent APs.
Residual conduction during adenosine administration predicts supraventricular tachycardia recurrence.
The technique is valuable for pathways that are mechanically inhibited or previously ablated.