Abstract 16908: Contact-force Controlled Catheter Ablation in Atrial Fibrillation Leads to Better Acute Results in Lesion Formation
Purposes: Contact-force (CF) measurement may increase the effectiveness of radiofrequency (RF) ablations in humans by allowing better control of the lesion size. The aim of this study is to compare RF ablation efficacy between CF- and no CF- guided catheter ablation in terms of time to pulmonary veins isolation (PVI), ablation technique and persistence of ablation effect in a patient population with atrial fibrillation (AF).
Methods: Eighteen patients with AF (9 male, 12 paroxysmal AF cases) received CF controlled percutaneous RF ablation (group 1) and were matched to an equal number of similar patients that underwent PVI with a regular open-irrigated tip catheter (group 2). Fluoroscopic time, total procedural time and time to obtain PVI in each pair of PV was compared between the 2 groups, as well the success of ablation at the end of one contiguous circular ablation line around each pair of PV and the number of acute PV reconnections.
Results: X-ray time (11 ± 3.7 min vs. 11.2 ± 3.8 min, p=0.952) and procedural time (108.3 ± 10.29 min vs. 110 ± 14.4 min, p= 0.733) in paroxysmal AF cases did not differ between the 2 groups. Time to isolate left-sided PV was significantly lower in group 1 (15.5 ± 5.8 min vs. 23.1 ± 12.4, p = 0.024) and was similar in right-sided PV isolation. Success of ablation at the end of one contiguous ablation circle was obtained in 16 patients (88.8%) in group 1 and only in 8 (44.4%) in group 2 (p = 0.003). Acute reconnection after the initial PVI was noted in 2 patients in group 1 (11.2%) and 9 (50%) in group 2 (p = 0.016). CF values ranged from 3.9 ± 2.5 g to 26.6 ± 10.4 g and from 5.6 ± 1.7 g to 34.9 ± 6.1 g in left sided PV and right sided PV respectively and allowed adjustment of power and duration energy delivery. The lowest values of CF were observed in antero-inferior regions of both left and right pairs of PV (5.8 ± 3.2 g and respectively 14.4 ± 9.9 g) and the highest in postero-lateral region in both sides (17.4 ± 9.2 g, median 16.6 g and respectively 17.4 ± 9.2 g, median 16.1g).
Conclusions: The use of CF sensing catheter in our study improved significantly the effectiveness of RF ablation as evidenced by time to PVI, success of single circle PVI and number of acute reconnections. There are significant differences in average CF in different regions of the PV antra.
- © 2012 by American Heart Association, Inc.