Abstract 9757: Atrial Rhythm Influences Catheter Tissue Contact During Radiofrequency Ablation of Atrial Fibrillation
Introduction: Radiofrequency catheter ablation (RFCA) is an accepted treatment option for symptomatic atrial fibrillation (AF). Catheter tissue contact force(CF) is one of the critical factors for transmural and durable lesion. Low CF may lead to insufficient lesion formation, whereas excessively high CF is associated with potential major complications. Recent studies showed that CF correlates with clinical outcome in patients with AF undergoing RFCA. An average CF of 10-30g is considered as an optimal target to avoid gap formation. Since CF varies in the beating heart, atrial rhythm during ablation may influence tissue contact.
Hypothesis: We assessed the hypothesis that atrial rhythm influences CF during RFCA of AF.
Methods: In this prospective study, a CF-sensing catheter (Tacticath, St. Jude Medical) was used in 18 patients undergoing RFCA of AF. Each pulse was delivered point by point with use of a steerable sheath (Agilis, St. Jude Medical) and the operator blinded to the CF information. Type of contact (constant, variable and intermittent) and mean CF were analysed according to atrial rhythms (sinus rhythm (SR) vs. AF).
Results: A total of 1003 points (694 points during SR and 309 points during AF) were analysed. Mean CF showed no significant difference between SR (16.6 ± 11.0g) and AF (17.1 ± 13.2g; p=0.54). The distribution of ablation points with a mean CF of >20g and <10g showed also no significant difference. However, the distribution of excessive high CF (CF >40g) was higher during AF (6.5%) compared with SR (3.5%; p<0.05). Constant contact was significantly higher during AF (28.6%) compared with SR (10.8%; p<0.05).
Conclusions: Although mean CF was not different during AF and SR, constant contact was more often achievable during AF compared with SR. However, excessive high CF also seems to occur more frequent during AF.
Author Disclosures: H. Matsuda: None. A.S. Parwani: None. P. Attanasio: None. M. Huemer: None. A. Wutzler: None. F. Blaschke: None. W. Haverkamp: None. L. Boldt: None.
- © 2014 by American Heart Association, Inc.