Abstract 17342: Invivo Contact Force Measurement and Catheter Stability during Left Atrial Mapping and Ablation
Background: Little is reported about invivo contact force (CF) measurement during left atrial (LA) mapping and ablation. The aim of this study was to evaluate invivo CF and the catheter stability during LA mapping.
Methods: CF during LA mapping were assessed in 23 patients undergoing atrial fibrillation ablation using a commercially available CF catheter. CF data was averaged every 50 ms and 1.2 second segments were analyzed. As a parameter of the catheter stability, coefficient of variance (COV = standard deviation of CF/average of CF) was adopted. During the procedure, operators were blinded to CF data. Data were analyzed according to 11 predefined areas: LA posterior, roof, anteroseptum, posteroseptum, anterior, anterior roof, mitral isthmus, LA inferior, inferior to mitral valve, left atrial appendage (LAA), and ridge.
Results: A total of 2668 mapping points were analyzed in 23 patients. Mean CF was 19.1±18.6 g. CF values ranged from 7.4±6.9 g on the ridge to 35.0±26.5 g in the anterior roof site (Table). CF was significantly higher at the anterior roof, roof, LA posterior, and posteroseptum than at the remaining sites. In the areas of ridge, LAA, and mitral isthmus, average CF was significantly lower than at the remaining areas. Low CF <10g was observed in 1057 points (40%). High CF≥40g was noted in 298 points (11%), particularly in areas of anterior roof (94 points [34%]), and roof (74 points [28%]). Excessive high CF≥100g was noted in 16 patients (70%) at 57 points (2%) and was located mainly at the areas of the anterior roof (32 points[12%]), roof (16 points[6%]), LA posterior (4 points[1%]). In the LAA, mitral isthmus, and ridge, COV were significantly larger as compared to the remaining areas (Table), suggesting catheter instability in these areas.
Conclusion: Very low as well as excessive high CF frequently occurs during left atrial mapping. CF monitoring may avoid complications related to excessive high CF as well as ineffective lesion formation related to very low CF.
- © 2012 by American Heart Association, Inc.