Adenosine can improve the intra-atrial conduction block along the mitral annulus during accessory pathway ablation.

A 10-year-old boy with a supraventricular tachycardia was referred for catheter ablation. An electrophysiologic study revealed a left lateral concealed accessory pathway (AP). A few radiofrequency (RF) applications targeting the AP resulted in an inadvertent intra-atrial conduction block at the mitral isthmus without any damage to the AP. Adenosine was then administered during left ventricular pacing. Soon after that, the conduction at the mitral isthmus recovered partially, and that change disappeared soon. Those findings suggested that the administration of adenosine may transiently recover the conduction at the mitral isthmus damaged by RF ablation.