Abstract 20793: Atrial Fibrillation Ablation Guided by Contact Force Measurement vs Standard Techniques: An Updated Systematic Review and Metaanalysis of Fifteen Studies
Introduction: Contact force (CF) below 10g during afib ablation is associated with non-transmural lesions, but extremely high CF increases risk of perforation and other complications.
Hypothesis: We tested the hypothesis that real-time CF sensing improves effectiveness of afib ablation and decreases risks.
Methods: We conducted a systematic search of PubMed. We included studies that compared CF-guided afib ablation to standard afib ablation. Primary outcomes were afib recurrence rates and major complication rates.
Results: We retrieved 654 publications and 15 studies were eligible for inclusion. The studies included 1133 CF guided ablations and 1652 controls. TactiCath catheter was used in 3 studies, ThermoCool SmartTouch in 9 studies, and 3 studies did not specify the CF sensing catheter used. The experimental and control groups were similar in their baseline characteristics including age ( 61.1 ± 10.7 VS 60 ± 10.2 years), gender (32% vs 33% female), hypertension (47% VS 51%), ischemic heart disease (11% VS 10% ), LA diameter ( 41.2 ± 7.1 VS 42.2 ± 6.7 mm), and paroxysmal afib ( 66% VS 65%). The mean CF achieved in the experimental group was 14.5 ± 8.1g. Use of CF sensing technology reduced afib recurrence between 10 weeks and 53 months (37% VS 45% OR = 0.71 [0.56;0.91]). Radiofrequency ablation times and total procedure times were shorter by an average of -4.54 [-8.14, -0.95] minutes and -18.5 [-34.0, -3.1] minutes respectively, but fluoroscopy time was unchanged (-0.52 [-8.43, 7.39] minutes). Major complications were also lessened (1.7% VS 4.6% OR = 0.41 [0.18,0.94]) but minor complication rates remained similar (10% VS 7%).
Conclusions: CF sensing catheters improve effectiveness, procedure times, and major complication rates of afib ablation.
Figure 1: Afib Recurrence Rates Forest Plot
Author Disclosures: O. Kreidieh: None. J. Pino: None. B. Kreidieh: None. J. Choi: None. J. Valente: None. R. Fishel: None. R. Chait: None.
- © 2016 by American Heart Association, Inc.