Intravenous ATP Challenge
We performed ATP challenge testing after a 60-minute waiting time since
initial documentation of PV/BOX isolation.
Intravenous ATP (20 mg) was administered with immediate saline flush
during an intravenous ISP infusion (0.5 to 1.0 μg/min). The dose of ISP
infusion was adjusted to increase the heart rate over 100 beats per
minute.
The ATP effect was confirmed by the presence of temporary bradycardia
and a decrease in blood pressure.
Double Lasso catheters were placed at the antrum of four PVs and/or SVC
during the ATP challenge. If dormant PV conduction was identified,
additional RF energy was applied to establish complete PV/BOX and/or SVC
disconnection. Repeat ATP injections during ISP infusion were performed
to reconfirm the complete disconnection of them.