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Contact force atrial

Girish M Nair, Roshan Raut, Karan Bami, Pablo B Nery, Calum J Redpath, Mouhannad M Sadek, Martin S Green, David H Birnie
PURPOSE OF REVIEW: Pulmonary vein reconnection leading to recurrence of atrial arrhythmias after pulmonary vein isolation (PVI) for atrial fibrillation remains a significant challenge. A number of adjunctive measures during PVI have been used to attempt to reduce pulmonary vein reconnection and recurrence of atrial arrhythmias. We performed a systematic review of the literature and meta-analysis of studies evaluating the efficacy of adjunctive measures used during PVI in reducing recurrent atrial arrhythmias...
October 15, 2016: Current Opinion in Cardiology
Melanie A Gunawardene, Boris A Hoffmann, Benjamin Schaeffer, Da-Un Chung, Julia Moser, Ruken Oezge Akbulak, Mario Jularic, Christian Eickholt, Jana Nuehrich, Christian Meyer, Stephan Willems
INTRODUCTION: Comparative data of early recurrence rates of atrial fibrillation (ERAF) following second-generation cryoballoon (CB-G2) and radiofrequency current (RFC) ablation for pulmonary vein isolation (PVI) in paroxysmal AF (PAF) are rare. We randomized PAF patients into either PVI with CB-G2 (group 1) or PVI with a combined RFC-approach applying contact force (CF) with the endpoint of unexcitability (group 2) to investigate ERAF. METHODS: In group 1 (n = 30), CB-G2-PVI was performed...
October 14, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Jingbo Jiang, Jinyi Li, Guoqiang Zhong, Junjun Jiang
PURPOSE: Currently, radiofrequency (RF) and cryoballoon are the most commonly used ablation technologies for atrial fibrillation (AF). We performed a meta-analysis to assess the efficacy and safety of the second-generation cryoballoons (CB-2) compared with RF for paroxysmal atrial fibrillation (PAF) ablation. METHODS: The PubMed, Cochrane Library, and Embase databases were searched and qualified studies were identified. The primary clinical outcome was the recurrence rate of atrial tachyarrhythmia (AT), and the secondary clinical outcomes were procedure time, fluoroscopy time, and the complications that followed...
September 28, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Paul A Gould, Cameron Booth, Kieran Dauber, Kevin Ng, Andrew Claughton, Gerald C Kaye
INTRODUCTION: This study sought to investigate specific contact force (CF) parameters to guide Cavotricuspid Isthmus (CTI) ablation and compare the outcome with a historical control cohort. METHODS AND RESULTS: Patients (30) undergoing CTI ablation were enrolled prospectively in the Study cohort and compared with a retrospective Control cohort of 30 patients. Ablation in the Study cohort was performed using CF parameters >10g and < 40 g and a Force Time Integral (FTI) of 800 ± 10 gs...
August 29, 2016: Journal of Cardiovascular Electrophysiology
Edouard Gitenay, Gilles Edouard O' Hara, Jean-François Sarrazin, Isabelle Nault, François Philippon, Marie Sadron Blaye-Felice, Jamal Laaouaj, Jean Champagne
Contact-force (CF) catheters appear to be more effective compared to standard ablation catheters for complex radiofrequency ablation including atrial fibrillation (AF) ablation when optimal CF >10 g is achieved. Some have suggested that this technology could also improve procedural safety. We report 2 cases of atrioesophageal fistulae (AEF), a rare but catastrophic complication of AF ablation. These are to our knowledge the first cases of AEF described after using CF catheters.
August 22, 2016: Journal of Cardiovascular Electrophysiology
Philipp Halbfass, Patrick Müller, Karin Nentwich, Joachim Krug, Markus Roos, Karsten Hamm, Sebastian Barth, Attila Szöllösi, Andreas Mügge, Bernhard Schieffer, Thomas Deneke
AIMS: Oesophageal probes to monitor luminal oesophageal temperature (LET) during atrial fibrillation (AF) catheter ablation have been proposed, but their effects remain unclear. Aim of this study is to evaluate the effects of an oesophageal temperature probe with insulated thermocouples. METHODS AND RESULTS: Patients with symptomatic, drug-refractory paroxysmal or persistent AF who underwent left atrial radiofrequency (RF) catheter ablation were prospectively enrolled...
August 18, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Alex J A McLellan, Matthew G D Bates, Shane D F Young, Paul B Sparks
Deglutition-induced atrial tachycardia is a rare arrhythmia with a poor response to medical therapy. Electrophysiological study is challenging due to the dependence of induction on swallowing. We present a novel approach to management of deglutition-induced atrial tachycardia arising from right superior pulmonary vein. Use of minimal conscious sedation and repeated swallow challenge inductions, together with contact force-guided mapping were key determinants of success. We review published cases, discussing potential mechanisms including oesophageal distension and neural reflexes...
November 2016: Heart, Lung & Circulation
Stefan Asbach, Corinna Lang, Luca Trolese, Christoph Bode, Fabienne Schluermann
PURPOSE: Recovery of pulmonary vein (PV) conduction is a common mechanism of atrial fibrillation recurrence after PV isolation (PVI), underscoring the need for durable lesion formation. We aimed to evaluate the utility of an automated lesion annotation algorithm (ALAA) on acute isolation rates and resulting lesion characteristics. METHODS: Fifty patients underwent PVI using a contact force (CF) sensing catheter and ALAA. Single antral circles around ipsilateral PVs were performed with ALAA-1 settings including catheter stability (range of motion ≤2 mm, duration >10 s)...
August 10, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Naofumi Anjo, Shiro Nakahara, Yasuo Okumura, Yuichi Hori, Koichi Nagashima, Takaaki Komatsu, Akiko Hayashi, Sayuki Kobayashi, Yoshihiko Sakai, Isao Taguchi
BACKGROUND: A high catheter tip-tissue contact force (CF) with the myocardium may cause 3-dimensional (3D) map distortion, however, the influence of external structures surrounding the left atrium (LA) on that distortion remains unknown. This study characterized the impact of high CF mapping on the local LA geometry distortion. METHODS: Thirty AF patients underwent 3D-ultrasound merged with CT images (3D-Merge-CT). The LA area in contact with external structures was identified by enhanced CT...
November 1, 2016: International Journal of Cardiology
Arash Aryana, Sheldon M Singh, Giacomo Mugnai, Carlo de Asmundis, Marcin Kowalski, Deep K Pujara, Andrew I Cohen, Steve K Singh, Charles E Fuenzalida, Nelson Prager, Mark R Bowers, Padraig Gearoid O'Neill, Pedro Brugada, André d'Avila, Gian-Battista Chierchia
PURPOSE: Catheter ablation of atrial fibrillation (CAAF) using the cryoballoon has emerged as an alternate strategy to point-by-point radiofrequency. However, there is little comparative data on long-term durability of pulmonary vein (PV) isolation comparing these two modalities. METHODS: In this multicenter, retrospective analysis, the incidences/patterns of late PV reconnection following an index CAAF using the second-generation cryoballoon versus open-irrigated, non-force-sensing radiofrequency were examined...
July 30, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Raphael Rosso, Ehud Chorin, Yuval Levi, Ori Rogowski, Sami Viskin
INTRODUCTION: Pulmonary vein isolation (PVI) with radiofrequency (RF) ablation is now standard care for atrial fibrillation (AF). New improvements in PVI techniques include use of catheters that measure contact-force and circular ablation catheters. These techniques have not been compared. METHODS AND RESULTS: We compared the success rate of circumferential pulmonary vein isolation (CPVI) with: (1) "point by point" RF using an irrigated tip ablation catheter with "smart touch" contact-force; (2) irrigated nMARQ circular ablation catheter in 86 patients with AF...
July 29, 2016: Journal of Cardiovascular Electrophysiology
Rhanderson Cardoso, Rodrigo Mendirichaga, Gilson Fernandes, Chris Healy, Litsa K Lambrakos, Juan F Viles-Gonzalez, Jeffrey J Goldberger, Raul D Mitrani
INTRODUCTION: Radiofrequency (RF) and cryoballoon (CB) catheter ablation are effective for pulmonary vein isolation (PVI) in atrial fibrillation (AF). This report presents an updated meta-analysis comparing the efficacy and safety of CB versus RF ablations in AF. METHODS: Databases and conference abstracts were systematically searched for studies that directly compared CB and RF PVI, and reported safety or efficacy outcomes in follow-up ≥12 months. Recurrent atrial tachyarrhythmias (AT) were defined as AF, atrial flutter, or atrial tachycardia...
July 16, 2016: Journal of Cardiovascular Electrophysiology
Kohki Nakamura, Shigeto Naito, Takehito Sasaki, Kentaro Minami, Yutaka Take, Satoru Shimizu, Yoshiaki Yamaguchi, Toshiaki Yano, Michiharu Senga, Eiji Yamashita, Yoshinao Sugai, Koji Kumagai, Nobusada Funabashi, Shigeru Oshima
PURPOSE: We aimed to identify the predictors of chronic pulmonary vein reconnections (CPVRs) after contact force (CF)-guided circumferential PV isolation (CPVI) of atrial fibrillation (AF). METHODS: Forty-nine consecutive patients undergoing second ablation procedures for recurrent AF after CF-guided ablation were retrospectively studied. The CPVI was performed by point-by-point ablation with a target CF of 15-20 g. The incidence of CPVRs was evaluated along the right- and left-sided anterior and posterior CPVI regions (Ant-RPVs, Post-RPVs, Ant-LPVs, and Post-LPVs)...
July 14, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Michele Brunelli, Markus Frommhold, Dieter Back, Marco Mierzwa, Bernard Lauer, J Christoph Geller
A 70-year-old woman with persistent atrial fibrillation underwent pulmonary vein isolation and linear ablation with a contact sensor catheter. During cavotricuspid isthmus ablation, a steam pop resulted in cardiac tamponade, and the patient developed severe hypotension despite successful pericardial puncture and minimal residual pericardial effusion. Right coronary artery angiography revealed extravasal contrast medium accumulation posterior of the Crux Cordis. Emergent cardiac surgery confirmed isolated disruption of the artery in the absence of additional heart perforation...
July 2016: Pacing and Clinical Electrophysiology: PACE
Sandrine Venier, Jason G Andrade, Paul Khairy, Blandine Mondésert, Katia Dyrda, Léna Rivard, Peter G Guerra, Marc Dubuc, Bernard Thibault, Mario Talajic, Denis Roy, Laurent Macle
AIMS: It remains unknown whether contact force (CF) sensing technology is of value for cavotricuspid isthmus (CTI) ablation. We prospectively evaluated procedural parameters and outcomes of CF-guided vs. CF-blinded CTI ablation for typical atrial flutter (AFL). METHODS AND RESULTS: A total of 70 consecutive patients (62.5 ± 10.9 years) undergoing CTI ablation for AFL were prospectively enrolled, 35 in CF-blinded and 35 in CF-guided groups. A CF-sensing catheter (power 25-35 W) was used in all...
July 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Pieter W J Lozekoot, Monique M J de Jong, Orlando Parise, Francesco Matteucci, Fabiana Lucà, Narendra Kumar, Daniele Bani, Jens Czapla, Laurent Pison, Harry J G M Crijns, Jos G Maessen, Mark La Meir, Sandro Gelsomino
OBJECTIVE: We present the first testing study on the ABLA-BOX, a new in vitro module of hybrid atrial fibrillation ablation. METHODS: ABLA-BOX consists of two chambers that mimic the epicardial and endocardial sides of the heart. The septum between chambers provides catheter access on both sites of the cardiac tissue. A circuit, filled with freshly obtained porcine blood, including a pump, an oxygenator, and a heating device, circulate the blood inside the system...
May 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Philipp Halbfass, Karin Nentwich, Joachim Krug, Markus Roos, Kai Sonne, Elena Ene, Karsten Hamm, Sebastian Barth, Attila Szöllösi, Franziska Fochler, Andreas Mügge, Ulrich Lüsebrink, Thomas Deneke
AIMS: Aim of this study was to evaluate the impact of a recently introduced contact force ablation catheter with modified irrigation technology compared with a conventionally irrigated ablation catheter on the incidence of endoscopically detected oesophageal lesions (EDEL). METHODS AND RESULTS: Patients with symptomatic, drug-refractory paroxysmal or persistent atrial fibrillation (AF) who underwent left atrial radiofrequency (RF) catheter ablation were prospectively enrolled...
June 27, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Attila Kardos, Zsuzsanna Kis, Zoltan Som, Zsofia Nagy, Csaba Foldesi
Background. There are little comparative data on catheter ablation of paroxysmal atrial fibrillation (AF) using the contact force radiofrequency (CF-RF) catheter versus the second-generation cryoballoon (CB2). Methods and results. This is a single center, retrospective, nonrandomized study of 98 patients with symptomatic, drug-refractory paroxysmal AF who underwent their first PVI ablation using either the CB2 (n = 40) or CF-RF (n = 58). The mean age was 60 years with 63% men, a mean LA size of 42 mm. The procedure duration (74 ± 17 versus 120 ± 49 minutes p < 0...
2016: BioMed Research International
Yasuo Okumura, Ichiro Watanabe, Kazuki Iso, Koichi Nagashima, Kazumasa Sonoda, Naoko Sasaki, Rikitake Kogawa, Keiko Takahashi, Kimie Ohkubo, Toshiko Nakai, Shiro Nakahara, Yuuichi Hori, Atsushi Hirayama
BACKGROUND: The clinical utility of an automated lesion tagging module based on catheter stability information (VisiTag) with the CARTO system during atrial fibrillation (AF) ablation remains to be established. We investigated whether VisiTag-guided extensive encircling pulmonary vein isolation (EEPVI) produces durable lesions. METHODS: The study involved 54 patients undergoing EEPVI for paroxysmal AF. We performed EEPVI guided by the module-generated ablation tags, i...
June 9, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Moloy Das, Jonathan J Loveday, Gareth J Wynn, Sean Gomes, Yawer Saeed, Laura J Bonnett, Johan E P Waktare, Derick M Todd, Mark C S Hall, Richard L Snowdon, Simon Modi, Dhiraj Gupta
AIMS: Force-Time Integral (FTI) is commonly used as a marker of ablation lesion quality during pulmonary vein isolation (PVI), but does not incorporate power. Ablation Index (AI) is a novel lesion quality marker that utilizes contact force, time, and power in a weighted formula. Furthermore, only a single FTI target value has been suggested despite regional variation in left atrial wall thickness. We aimed to study AI's and FTI's relationships with PV reconnection at repeat electrophysiology study, and regional threshold values that predicted no reconnection...
May 31, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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