Abstract 17742: Novel Temperature Power Ratio Tracking Estimates Sufficiency of Contact Force During Wide Area Circumferential Ablation
Background: Contact force (CF) sensing catheters may help optimize assessment of lesion creation during atrial fibrillation (AF) ablation. Whether other surrogate markers may offer an alternative to contact force is unclear. We proposed the use of a novel ratio of mean temperature/mean power (T/P) during ablation to assess contact force (CF).
Methods: We retrospectively reviewed ablation points in 10 cases with 1000 energy deliveries where fixed time intervals (>20s) were used for individual lesions using CF technology and CARTO 4® (Biosense Webster) 3D mapping systems. We calculated the T/P ratio in these lesions. This ratio was then applied to ablation points in 5 other cases with 450 ablative lesions to determine predictive accuracy for a CF>10g.
Results: A T/P ratio of 1.5 ± 0.4 was found to be present during ablation with CF>10g in the LA. The lower cutoff of this ratio (1.1) was applied to 450 points in a validation cohort to predict CF. This ratio had a high sensitivity 92.6% with a correlation co-efficient of 0.67 and negative predictive value of 87.6 % in predicting CF<10-25 g (p value =0.0001).The correlation of the values cross various groups of CF is as per Figure 1. No significant correlation was found with the CF at ratios of >1.9 or below 1.1. Forces beyond 25 g and below 10g also did not correlate to this ratio.
Conclusions: Use of the novel T/P ratio can guide contact assessment when ablating in the LA. Maximal sensitivity is in the working range of CF between 10-25 g and this enables tracking of contact force without the expense and potential risk of stiff CF catheters
Author Disclosures: D. Padmanabhan: None. A. Garg: None. P. Chacko: None. S. Kapa: None. S. Mulpuru: None. P. Noseworthy: None. D.L. Packer: Research Grant; Significant; American Heart Association Foundation Award, Biosense Webster, Boston Scientific/EPT, CardioInsight, CardioFocus, Endosense, Hansen Medical, Medtronic CryoCath LP, NIH, St. Jude Medical, Siemens, Thermedical. Honoraria; Significant; Abbott Laboratories/Topera, Aperture Diagnostics $0, Biosense Webster $0, Boston Scientific $0, CardioFocus $0, CardioInsight $0, Johnson & Johnson Healthcare Systems $0, Johnson & Johnson $0, MediaSphere Medical, , Medtronic CryoCath $0, Siemens $0, St. Jude Medical $0, Topera. Other; Significant; Royalties: St. Jude Medical, Royalties: Analyze-AVW technology, Royalties: Wiley and Sons.
- © 2016 by American Heart Association, Inc.