Electrophysiological Evaluation Practice Test

Dormant conduction after pulmonary vein isolation can hide gaps in the lesion set that permit return of conduction from the pulmonary vein to the left atrium. Adenosine provocation is used to unmask this latent PV–atrial conduction. Adenosine transiently alters atrial tissue excitability and refractoriness, which can temporarily restore conduction through nontransmural or concealed gaps that the ablation lines didn’t fully block. If conduction reappears under adenosine, it indicates a need for additional targeted ablation to achieve durable isolation.

Oxygen saturation is just a physiologic measurement, not a provocative agent for conduction; beta-blockers affect heart rate and AV conduction without specifically revealing PV–atrial conduction; vasovagal maneuvers alter autonomic tone but don’t unmask PV conduction paths.