Abstract 17234: The EFFICAS Studies: Reducing Low Force-Time Integral (FTI) Radiofrequency Applications Improves Procedural Efficacy During Pulmonary Vein Isolation
Objectives Results of the EFFICAS I study illustrate that in patients with paroxysmal atrial fibrillation (PAF) undergoing pulmonary vein isolation (PVI), ablation using low Force-Time Integral (FTI <400 gs) predicts early gap formation. The EFFICAS II multicenter study prospectively evaluated whether limiting the number of low FTI ablations during PVI improves procedural efficacy.
Methods Patients with PAF underwent PVI using an ablation catheter with an integrated Contact Force (CF) sensor (TactiCath®, Endosense, Switzerland). Operators were requested to start ablation when CF was ≥ 10 g and to avoid ablations with FTI < 400 gs, thereby demonstrating good catheter stability. Procedure duration, RF ablation time, number of ablations for PVI and fluoroscopy time were compared between EFFICAS I and EFFICAS II.
Results Five operators in 3 centers treated 30 patients in EFFICAS I and 34 patients in EFFICAS II. All PVs (100%) were isolated at the end of the procedure. In EFFICAS I, 42% of 2060 ablations were performed with an FTI < 400 gs, compared to 18% of 1860 ablations applied in EFFICAS II. There was a statistically significant reduction in RF ablation time, number of ablations, and fluoroscopy time in EFFICAS II as compared to EFFICAS I (table).
Conclusions Reducing the number of radiofrequency ablations with an FTI < 400 gs increases the efficacy of ablation during PVI. Whether more effective ablation will increase safety and improve outcome following PVI needs to be determined.
- © 2011 by American Heart Association, Inc.