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Atrial Fibrillation Long-term outcome contact force

Stefano Grossi, Francesco Grassi, Lorenzo Galleani, Francesca Bianchi, Maria Rosa Conte
RATIONALE: Pulmonary vein isolation (PVI) is the method of choice for the treatment of drug-resistant atrial fibrillation (AF). However, arrhythmia recurrences are frequent due to suboptimal lesions formation and pulmonary vein reconnection. Contact force (CF)- and remote magnetic navigation (RMN)-guided catheters are both capable of improving contact and energy transfer to the tissue, possibly improving PVI outcome. OBJECTIVE: The objective of our study was to compare CF- and RMN-guided PVI in patients with paroxysmal AF in terms of surrogate parameters of the dimension and quality of the lesions...
February 6, 2018: Pacing and Clinical Electrophysiology: PACE
Tom De Potter, Hugo Van Herendael, Richard Balasubramaniam, Matthew Wright, Sharad C Agarwal, Prashanthan Sanders, Yaariv Khaykin, Decebal-Gabriel Latcu, Philippe Maury, Antonio Pani, John Hayes, Jonathan Kalman, Pablo Nery, Edward Duncan
Aims: Real-time contact force (CF)-sensing radiofrequency ablation catheter for treatment of paroxysmal atrial fibrillation (PAF) allows optimization of electrode-tissue contact, which correlates with long-term success. This prospective, multicentre observational registry assessed the real-world clinical effectiveness of a CF-sensing catheter for ablation of drug-refractory PAF. Methods and results: Patients were followed-up at 3, 6, and 12 months after ablation...
January 4, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Miki Yokokawa, Aman Chugh, Rakesh Latchamsetty, Hamid Ghanbari, Thomas Crawford, Krit Jongnarangsin, Ryan Cunnane, Mohammed Saeed, Kyle Hornsby, Kavita Krishnasamy, Watchara Lohawijarn, Robert Keast, David Karpenko, Frank Bogun, Frank Pelosi, Fred Morady, Hakan Oral
INTRODUCTION: Although noninferiority of cryoballoon ablation (CBA) and radiofrequency catheter ablation for antral pulmonary vein isolation (APVI) has been reported in patients with paroxysmal atrial fibrillation (PAF), it is not clear whether contact force sensing (CF-RFA) and CBA with the second-generation catheter have similar procedural costs and long-term outcomes. The objective of this study is to compare the long-term efficacy and cost implications of CBA and CF-RFA in patients with PAF...
February 2018: Journal of Cardiovascular Electrophysiology
Dipen Shah
In order to Improve the procedural success and long-term outcomes of catheter ablation techniques for atrial fibrillation (AF), an Important unfulfilled requirement is to create durable electrophysiologically complete lesions. Measurement of contact force (CF) between the catheter tip and the target tissue can guide physicians to optimise both mapping and ablation procedures. Contact force can affect lesion size and clinical outcomes following catheter ablation of AF. Force sensing technologies have matured since their advent several years ago, and now allow the direct measurement of CF between the catheter tip and the target myocardium in real time...
June 2017: Arrhythmia & Electrophysiology Review
Judit Szilágyi, Gregory M Marcus, Nitish Badhwar, Byron K Lee, Randall J Lee, Vasanth Vedantham, Zian H Tseng, Tomos Walters, Melvin Scheinman, Jeffrey Olgin, Edward P Gerstenfeld
BACKGROUND: The cornerstone of atrial fibrillation (AF) ablation is isolation of the pulmonary veins (PVs). Patients with recurrent AF undergoing repeat ablation usually have PV reconnection (PVr). The ablation strategy and outcome of patients undergoing repeat ablation who have persistent isolation of all PVs (PVi) at the time of repeat ablation is unknown. METHODS AND RESULTS: We studied consecutive patients with recurrent AF undergoing repeat ablation and compared patients with PVi to those with PVr...
April 21, 2017: Journal of Cardiovascular Electrophysiology
Akio Chikata, Takeshi Kato, Takanori Yaegashi, Satoru Sakagami, Chieko Kato, Takahiro Saeki, Keiichi Kawai, Shin-Ichiro Takashima, Hisayoshi Murai, Soichiro Usui, Hiroshi Furusho, Shuichi Kaneko, Masayuki Takamura
Compared to conscious sedation (CS), the use of general anesthesia (GA) in pulmonary vein isolation (PVI) is associated with a lower recurrence rate of atrial fibrillation (AF). GA may improve catheter stability and mapping system accuracy compared to CS, but its influence on contact force (CF) parameters during ipsilateral PVI has not previously been investigated. The study population comprised 176 consecutive patients (107 in GA group and 69 in CS group) with AF who underwent their first PVI procedure. We retrospectively assessed CF parameters, force-time integral (FTI), FTI/wall thickness during anatomical ipsilateral PVI and long-term outcome after ablation...
August 2017: Heart and Vessels
Jackson J Liang, Pasquale Santangeli
Catheter ablation is an effective treatment option for atrial fibrillation (AF), and pulmonary vein isolation (PVI) is the cornerstone of AF ablation. When AF recurs after ablation, PV reconnection is frequently seen during repeat ablation. As such, achieving durable chronic PVI by delivering effective, transmural lesions during the index ablation is key to optimize long-term outcomes. The development of contact force (CF) sensing technologies integrated into ablation catheters now allow for real-time visualization of applied CF during PVI and have been shown to improve ablation efficacy and safety...
June 2016: Expert Review of Cardiovascular Therapy
Taihei Itoh, Masaomi Kimura, Hirofumi Tomita, Shingo Sasaki, Shingen Owada, Daisuke Horiuchi, Kenichi Sasaki, Yuji Ishida, Takahiko Kinjo, Ken Okumura
AIMS: Although contact force (CF)-guided circumferential pulmonary vein isolation (CPVI) for paroxysmal atrial fibrillation (PAF) is useful, AF recurrence at long-term follow-up still remains to be resolved. The purpose of this study was to assess safety and efficacy of CF-guided CPVI and to compare residual conduction gaps during CPVI and long-term outcome between the conventional (non-CF-guided) and the CF-guided CPVI. METHODS AND RESULTS: We studied the 50 consecutive PAF patients undergoing CPVI by a ThermoCool EZ Steer catheter (conventional group, mean age 61 ± 10 years) and the other 50 consecutive PAF patients by a ThermoCool SmartTouch catheter (CF group, 65 ± 11 years)...
April 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Julian W E Jarman, Sandeep Panikker, Moloy DAS, Gareth J Wynn, Waqas Ullah, Andrianos Kontogeorgis, Shouvik K Haldar, Preya J Patel, Wajid Hussain, Vias Markides, Dhiraj Gupta, Richard J Schilling, Tom Wong
INTRODUCTION: Contact force sensing (CFS) technology improves acute pulmonary vein isolation durability; however, its impact on the clinical outcome of ablating atrial fibrillation (AF) is unknown. METHODS AND RESULTS: First time AF ablation procedures employing CFS from 4 centers were matched retrospectively to those without CFS in a 1:2 manner by type of AF. Freedom from atrial tachyarrhythmia was defined as the primary outcome measure, and fluoroscopy time the secondary outcome measure...
April 2015: Journal of Cardiovascular Electrophysiology
Jason G Andrade, George Monir, Scott J Pollak, Paul Khairy, Marc Dubuc, Denis Roy, Mario Talajic, Marc Deyell, Léna Rivard, Bernard Thibault, Peter G Guerra, Stanley Nattel, Laurent Macle
BACKGROUND: Atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) is associated with PV to left atrium reconduction. Effective lesion creation necessitates adequate contact force between the ablation catheter and myocardium. OBJECTIVE: The purpose of this study was to study the utility of contact force-guided ablation on immediate and long-term outcomes. METHODS: Seventy-five patients with highly symptomatic paroxysmal AF underwent wide circumferential PVI using an irrigated-tip radiofrequency catheter...
November 2014: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Masaomi Kimura, Shingo Sasaki, Shingen Owada, Daisuke Horiuchi, Kenichi Sasaki, Taihei Itoh, Yuji Ishida, Takahiko Kinjo, Hirofumi Tomita, Ken Okumura
BACKGROUND: Contact force (CF) monitoring could be useful in accomplishing circumferential pulmonary vein (PV) isolation (CPVI) for atrial fibrillation (AF). OBJECTIVE: The purpose of this study was to compare procedure parameters and outcomes between CF-guided and non-guided CPVI. METHODS: Thirty-eight consecutive AF patients (mean age 60 ± 11 years, 28 paroxysmal AF) undergoing CPVI were randomized to non-CF-guided (n = 19) and CF-guided (n = 19) groups...
June 2014: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Andreas Rillig, Boris Schmidt, Britta Feige, Erik Wissner, Andreas Metzner, Anita Arya, Shibu Mathew, Hisaki Makimoto, Peter Wohlmuth, Feifan Ouyang, Karl-Heinz Kuck, Roland Richard Tilz
BACKGROUND: Left atrial isthmus (LAI)-ablation in addition to circumferential pulmonary vein isolation (CPVI) may improve outcomes in select patients with atrial fibrillation (AF). However, bidirectional LAI-block is difficult to obtain. No systematic evaluation reporting on the feasibility and efficacy of LAI-ablation using a robotic navigation system (RNS) exists. METHODS AND RESULTS: In this pilot study, CPVI combined with LAI-ablation were performed using a RNS and 3D-mapping system in 42 patients with persistent (n = 24, 57...
December 2013: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
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