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Atrial Fibrillation Long-term outcome contact force

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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