Abstract 15817: Impact of Contact Force Visualization on Tissue to Catheter Contact Force During Pulmonary Vein Isolation
Background: The aim of this study was to evaluate the impact of contact force visualization on the tissue to myocardial contact force (CF) during pulmonary vein isolation (PVI) procedures
Methods: In 80 patients with atrial fibrillation, CF was assessed during circumferential PVI using a commercially available CF catheter in combination with a 3D electroanatomic mapping system. Operators were blinded to CF during the procedure in Group-A (35 pts) and CF was displayed to the operators in Group-B (45 pts). The catheter was maintained in a stable position for at least 30 seconds during ablation. Optimal CF was defined as mean CF of 10-40g which was also the target range for Group-B. Data from the first 30 seconds of each radiofrequency application were analyzed according to 6 predefined segments for the ipsilateral PVs (Figure ).
Results: PVI was successfully achieved in all patients. A total of 2436 applications were analyzed. Although overall mean CF was similar in both groups (18.2g vs. 19.0g, p=0.40), there were significant CF differences between the two groups at the roof, postero-superior and inferior segments of the right PV, and in the postero-superior, antero-superior and antero-inferior segments of the left PV (Figure ). In particular, median CF at anterior segments of the LPV was <10g in Group-A, compared to ≥10g in Group-B. Low CF (<10g), optimal CF, and high CF (≥40g) were recorded in 312 (29%), 540 (51%) and 215 (20%) applications in Group-A, and in 225 (15%), 1083 (75%) and 144 (10%) applications in Group-B, respectively. Optimal CF was achieved in significantly more applications in Group-B (p<0.001).
Conclusions: CF visualization can assist in avoiding both low and high CF during PVI, which may result in more durable lesion formation, and a more favorable patient safety profile.
- © 2013 by American Heart Association, Inc.