Abstract 17621: VisiTag as a New Promising Index of Optimal Lesion Formation During Atrial Fibrillation Ablation with Adequate Contact Force
Backgrounds: Contact force (CF) information is effective in accomplishing circumferential pulmonary vein (PV) isolation (CPVI). However, residual conduction gap still remains despite ablation with optimal CF in some patients.
Objective: Using a VisiTag module, we examined the influence of catheter position stability during CPVI to the residual conduction gap.
Methods: The consecutive 131 patients with atrial fibrillation (AF) (85 men; mean age, 63 years; paroxysmal AF, 101) undergoing CPVI using a Thermcool Smarttouch catheter were enrolled. CPVI was performed with target CF at 10-20 g and power at 25-30W without monitoring PV potentials. PV potentials were recorded with a lasso catheter before and after CPVI. In the initial 62, CPVI was performed only with CF information (CF group). In the other 69, it was performed using a VisiTag module installed on CARTO3 Version 3, in which force time index (FTI) was predetermined while setting filter thresholds at 5 seconds for the minimum time, 1 mm for the maximum range, 25% for the force over time, and 5g for the minimum force under the respiration adjustment. In the first 41 of the 69, target FTI was set at 80 g*sec (FTI80 group). In the other 28, it was at 50 g*sec (FTI50 group). The number of residual conduction gaps at each PV after CPVI, procedure and fluoroscopy time for CPVI were compared among groups.
Results: After CPVI procedure, no gaps were present in 21 (34%) patients in CF group, in 13 (32%) in FTI80 group, in 11 (50%) in FTI50 group. Mean number of residual gaps per person in these 3 groups were 1.4±1.4, 1.3±1.4 and 1.2±1.3, respectively (p=NS). In the left superior PV, those in FTI80 was smaller than those in CF (0.4±0.6, 0.2±0.4 and 0.2±0.4, respectively; p<0.05, CF vs FTI80). However, in the right inferior PV, those in FTI50 was smaller than those in FTI80 (0.5±0.6, 0.7±0.7 and 0.4±0.6, respectively; P<0.05, FTI80 vs FTI50). Procedure time (59±20, 70±24 and 57±19 minutes, respectively) and fluoroscopy time (59±256, 60±87 and 31±64 seconds, respectively) for CPVI were significantly lower in FTI50 than in FTI80 and CF (both P<0.05).
Conclusion: Catheter stability in addition to CF is important in accomplishing CPVI. Adequate FTI may need to be adjusted for optimal lesion formation in each PV.
Author Disclosures: M. Kimura: Honoraria; Modest; Johnson & Johnson K.K. S. Sasaki: Research Grant; Modest; Johnson & Johnson K.K. and Medtronic Japan Co., Ltd. H. Daisuke: Research Grant; Modest; Johnson & Johnson K.K. and Medtronic Japan Co., Ltd.. K. Sasaki: None. T. Itoh: None. Y. Ishida: None. T. Kinjo: None. K. Okumura: Honoraria; Modest; Johnson & Johnson K.K..
- © 2014 by American Heart Association, Inc.