Abstract 17218: The Use of Contact Force Data during Pulmonary Vein Isolation Translates into Improved Clinical Outcomes for Atrial Fibrillation Ablation Patients
Introduction Acute pulmonary vein (PV) reconnection is a known predictor of long-term success in AF ablation. Acute reconnection rates, 1 hour after electrical pulmonary vein isolation (PVI), varys from 24-50%. The advent of contact force (CF) sensing catheters allows for real-time analysis of CF during ablation, which may improve the efficacy of PVI.
Hypothesis We hypothesised that the use of CF data during PVI results in a lower acute PV reconnection rate.
Methods Patients with symptomatic AF were divided into ‘blinded’ and ‘unblinded’ groups. Twenty patients in each group (total 40 patients) underwent PVI using an irrigated tip catheter providing real-time analysis of tip-to tissue CF. RF energy was applied at 30W with a temperature limit of 48°C with the operator blinded to the CF sensor values in only the blinded group. After PVI confirmation, exit and entrance block were re-tested after 1 hour, including the use of intravenous adenosine challenge.
Results All 80 PVs (100%) in each group of 20 patients (62+/-13 yrs, 26 male) were successfully electrically isolated. The type of AF was equal in both groups (35% paroxysmal, 65% persistent). There was no statistical difference in baseline characteristics between both groups. Acute PV reconnection rates were significantly higher in the ‘blinded’ group than in the ‘unblinded’ group: 17/80 (21.3%) vs. 3/80 (3.8%); p=0.001 respectively (see Figure 1). Subjects in the ‘blinded’ group had a significantly lower geometric mean CF ratio of 0.94 (0.90,0.97) p=0.003. The actual geometric mean values in relation to the ratio were 13.14g CI 11.51,14.74 vs. 13.98g CI 12.79,15.20 respectively.
Conclusion In our single centre experience, the knowledge and use of CF data during PVI significantly lowers acute PV reconnection rates. This new technology improves the acute efficacy of PVI procedures, which may translate into superior long-term success rates from AF ablation. Figure1. Number of acute PV reconnections at PV and patient level
- © 2012 by American Heart Association, Inc.