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Contact force atrial

Baptiste Maille, Moloy Das, Ahmed Hussein, Matthew Shaw, Vivek Chaturvedi, Maureen Morgan, Christina Ronayne, Richard L Snowdon, Dhiraj Gupta
INTRODUCTION: The ConfiDENSE™ module (Carto3 v4) allows rapid annotation of endocardial electrograms acquired by multi-electrode (ME) mapping. However, its accuracy in assessing atrial voltages is unknown. METHODS AND RESULTS: Two ConfiDENSE™ left atrial voltage maps were created during continuous pacing in 20 patients undergoing catheter ablation for persistent AF using a ME lasso catheter and a Contact Force (CF) sensing ablation catheter. The automated Tissue Proximity indicator (TPI) filter was then applied to the ME map to yield a TPI map...
March 5, 2018: Journal of Cardiovascular Electrophysiology
Benjamin Schaeffer, Stephan Willems, Christian Meyer, Jakob Lüker, Ruken Ö Akbulak, Julia Moser, Mario Jularic, Christian Eickholt, Jana M Schwarzl, Melanie Gunawardene, Pawel Kuklik, Arian Sultan, Boris A Hoffmann, Daniel Steven
AIMS: Contact force (CF) catheters provide catheter-tissue contact information to improve outcome of pulmonary vein isolation (PVI) in paroxysmal atrial fibrillation (PAF). We evaluated different target-CF values for achievement of the additional endpoint of an unexcitable ablation line. METHODS: A total of 106 patients undergoing PVI were randomized into three groups (G) (G1: target-CF 15 g, G2: target-CF 10 g, G3: CF concealed from operator). The PVI encircling line was divided into predefined sections...
March 2, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Roger A Winkle, Ryan Moskovitz, R Hardwin Mead, Gregory Engel, Melissa H Kong, William Fleming, Jonathan Salcedo, Rob A Patrawala, John H Tranter, Isaac Shai
PURPOSE: The optimal radiofrequency (RF) power and lesion duration using contact force (CF) sensing catheters for atrial fibrillation (AF) ablation are unknown. We evaluate 50 W RF power for very short durations using CF sensing catheters during AF ablation. METHODS: We evaluated 51 patients with paroxysmal (n = 20) or persistent (n = 31) AF undergoing initial RF ablation. RESULTS: A total of 3961 50 W RF lesions were given (average 77...
February 19, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Kurt S Hoffmayer, Felix Krainski, Sanjay Shah, Jessica Hunter, Maylene Alegre, Jonathan C Hsu, Gregory K Feld
BACKGROUND: Radiofrequency catheter ablation (RFCA) of the cavo-tricuspid isthmus (CTI) is a common treatment for atrial flutter (AFL). However, achieving bi-directional CTI conduction block may be difficult, partly due to catheter instability. OBJECTIVE: To evaluate the safety and efficacy of the Amigo® Remote Catheter System (RCS) compared to manual catheter manipulation, during CTI ablation for AFL. METHODS: Fifty patients (pts) were prospectively randomized to robotically (25 pts) versus manually (25 pts) controlled catheter manipulation during CTI ablation, using a force-contact sensing, irrigated ablation catheter...
February 12, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Mario Matta, Matteo Anselmino, Federico Ferraris, Marco Scaglione, Fiorenzo Gaita
BACKGROUND: Radiofrequency and cryoballoon pulmonary vein isolation are common approaches for paroxysmal atrial fibrillation treatment, showing similar results in recent multicenter studies, including heterogeneous tools and protocols. The aim of this study is to compare prospectively in a single, high-volume center the outcome of paroxysmal atrial fibrillation ablation performed specifically by second-generation cryoballoon or contact force radiofrequency ablation. METHODS: Consecutive patients scheduled for paroxysmal atrial fibrillation transcatheter ablation have been included and prospectively followed up...
April 2018: Journal of Cardiovascular Medicine
Giulio Zucchelli, Giusy Sirico, Luca Rebellato, Massimiliano Marini, Giuseppe Stabile, Maurizio Del Greco, Antonello Castro, Ermenegildo De Ruvo, Ezio Soldati, Gianluca Zingarini, Salvatore Ocello, Elisabetta Daleffe, Massimo Mantica, Claudio Pandozi, Massimiliano Maines, Fabrizio Guarracini, Maria Grazia Bongiorni
BACKGROUND: Our aim was to evaluate the clinical outcome of paroxysmal atrial fibrillation (AF) ablation with contact force technology, using an automated lesion tagging system (VISITAGTM module) with strict criteria of catheter stability.Methods and Results:We enrolled 200 consecutive patients who underwent pulmonary vein isolation (PVI) in 11 centers and were followed up for 12 months. The stability setting was within 3 mm for ≥10 s and for ≥15 s in 47% and 53% of patients, respectively...
February 8, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Thomas J Buist, Ahmet Adiyaman, Jaap Jan J Smit, Anand R Ramdat Misier, Arif Elvan
INTRODUCTION: The aim of this study was to compare second-generation cryoballoon and contact-force radiofrequency point-by-point pulmonary vein isolation (PVI) in atrial fibrillation (AF) patients with regard to pulmonary vein reconnection and arrhythmia-free survival. METHODS AND RESULTS: Altogether, 269 consecutive patients with drug-refractory AF undergoing PVI were included and randomly allocated to second-generation cryoballoon or contact-force point-by-point radiofrequency ablation...
February 6, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Ahmed AlTurki, Riccardo Proietti
Recurrence of atrial fibrillation after pulmonary vein isolation is mainly due to pulmonary vein reconnection. Contact force sensing catheters that allow operators to assess and optimize the degree of contact as well as remote magnetic navigation which facilitates intracardiac catheter steering and improves catheter stability are two technological advances designed to improve catheter ablation outcomes by enhancing the ablation lesion. Lesion dimension can be assessed indirectly via electrogram signal attenuation and impedance drop...
February 6, 2018: Pacing and Clinical Electrophysiology: PACE
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 frequently 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
Mark O'Neill, Steven E Williams
No abstract text is available yet for this article.
January 29, 2018: Journal of Cardiovascular Electrophysiology
Mihail G Chelu, Alan K Morris, Eugene G Kholmovski, Jordan B King, Gagandeep Kaur, Michelle A Silver, Joshua E Cates, Frederick T Han, Nassir F Marrouche
INTRODUCTION: Adequate catheter/atrial tissue contact is critical for lesion formation during radiofrequency (RF) ablation of atrial fibrillation (AF). Late gadolinium enhancement magnetic resonance imaging (LGE-MRI) is a unique tool for the evaluation of lesion formation and detection of acute esophageal injury. METHODS: LGE-MRIs were obtained prior, within 24 hours of, and at 115±62 days after first AF ablation in 36 patients. The Visitag module of CARTO3 was used to collect contact force (CF) and duration from a CF sensing ablation catheter for each registered ablation point...
January 18, 2018: Journal of Cardiovascular Electrophysiology
Michael Wolf, Milad El Haddad, Joël Fedida, Philippe Taghji, Katarina Van Beeumen, Teresa Strisciuglio, Jan De Pooter, Caroline Lepièce, Yves Vandekerckhove, René Tavernier, Mattias Duytschaever, Sébastien Knecht
Aims: Achieving block across linear lesions is challenging. We prospectively evaluated radiofrequency (RF) linear ablation at the roof and mitral isthmus (MI) using point-by-point contiguous and optimized RF lesions. Methods and results: Forty-one consecutive patients with symptomatic persistent AF underwent stepwise contact force (CF)-guided catheter ablation during ongoing AF. A single linear set of RF lesions was delivered at the roof and posterior MI according to the 'Atrial LINEar' (ALINE) criteria, i...
January 8, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Thomas Phlips, Philippe Taghji, Milad El Haddad, Michael Wolf, Sébastien Knecht, Yves Vandekerckhove, René Tavernier, Mattias Duytschaever
Aims: We have recently shown that a contact force (CF)-guided ablation protocol respecting region-specific criteria of lesion contiguity and lesion depth ('CLOSE' protocol) is associated with high incidence of acute durable pulmonary vein (PV) isolation (PVI) and a high single-procedure arrhythmia-free survival at 1 year. In the present study, we compared efficiency, safety, and efficacy of 'CLOSE'-guided PVI to conventional CF-guided PVI (CONV-CF). Methods and results: Fifty consecutive paroxysmal atrial fibrillation (AF) patients underwent PV encircling using a CF-sensing catheter targeting an interlesion distance (ILD) ≤6 mm and ablation index (AI) ≥400 and ≥550 at posterior and anterior wall ('CLOSE' group)...
January 4, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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
Yasuo Okumura, Ichiro Watanabe, Kazuki Iso, Keiko Takahashi, Koichi Nagashima, Kazumasa Sonoda, Hiroaki Mano, Naoko Yamaguchi, Rikitake Kogawa, Ryuta Watanabe, Masaru Arai, Kimie Ohkubo, Sayaka Kurokawa, Toshiko Nakai, Atsushi Hirayama
Background: The mechanism explaining the efficacy of cryoballoon ablation (CBA) for atrial fibrillation has not been clarified. Methods and Results: We compared lesion characteristics between patients in whom pulmonary vein isolation (PVI) was performed by CBA (n=56) and those by contact force (CF)-based RF ablation (n=56). We evaluated the 3-dimensional PV morphology before and after cryoballoon inflation. After PVI, a 3D left atrial voltage map was created. Pacing (10 mA and 2 ms) was performed within the low voltage area from the ablation line, and electrically unexcitable ablated tissue was identified...
April 2017: Journal of Atrial Fibrillation
Mattias Duytschaever, Anthony Demolder, Thomas Phlips, Andrea Sarkozy, Milad El Haddad, Philippe Taghji, Sebastien Knecht, Rene Tavernier, Yves Vandekerckhove, Tom De Potter
Aims: Catheter ablation is indicated in patients with symptomatic paroxysmal atrial fibrillation (AF) resistant to antiarrhythmic drug therapy (ADT). We investigated whether continued use of previously ineffective ADT beyond the post-ablation blanking period reduces recurrence of atrial tachyarrhythmia within the 1st year after ablation. Methods and results: This was a multicentre, randomized controlled study in patients undergoing contact force-guided pulmonary vein isolation (PVI) for paroxysmal AF in whom previously ineffective ADT was continued during a blanking period of 3 months...
December 2, 2017: European Heart Journal
Bawer Jalal Tofig, Peter Lukac, Rune Borregaard, Jan Møller Nielsen, Henrik Kjærulf Jensen, Christian Gerdes, Jens Kristensen, Jens Cosedis Nielsen, Steen Buus Kristiansen
OBJECTIVES: Recurrent arrhythmia after pulmonary vein isolation (PVI) by radiofrequency (RF) ablation in patients with atrial fibrillation (AFIB) remains a significant challenge. Using contact force (CF) sensing ablation catheters, we aimed to identify procedure related parameters associated with recurrence after de-novo PVI in patients with AFIB. METHODS: Consecutive patients undergoing a de-novo PVI procedure (n = 120, 63% paroxysmal and 37% persistent AFIB) employing a force-sensing ablation catheter were included...
February 2018: Scandinavian Cardiovascular Journal: SCJ
Hideharu Okamatsu, Ken Okumura
Pulmonary vein (PV) antrum isolation (PVAI) is effective in treating paroxysmal atrial fibrillation (AF) but is less so for persistent AF. A recent randomized study on the ablation strategies for persistent AF demonstrated that 2 common atrial substrate modifications, creation of linear lesions in the left atrium and ablation of complex fractionated electrogram sites, in addition to PVAI did not improve the outcome compared with stand-alone PVAI, suggesting the necessity of a more individualized, selective approach to persistent AF...
December 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
T Jared Bunch
No abstract text is available yet for this article.
February 2018: Journal of Cardiovascular Electrophysiology
Masaharu Masuda, Masashi Fujita, Osamu Iida, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takashi Kanda, Akihiro Sunaga, Takuya Tsujimura, Yasuhiro Matsuda, Takuya Ohashi, Masaaki Uematsu
Aims: Before the discovery of contact-force guidance, eliminating pacing capture along the pulmonary vein (PV) isolation line had been reported to improve PV isolation durability and rhythm outcomes. DRAGON (UMIN-CTR, UMIN000015332) aimed to elucidate the efficacy of pace-capture-guided ablation following contact-force-guided PV isolation ablation in paroxysmal atrial fibrillation (AF) patients. Methods and results: A total of 156 paroxysmal AF patients with AF-trigger ectopies from any of the four PVs induced by isoproterenol were randomly assigned to undergo pace-capture-guided ablation along a contact-force-guided isolation line around AF-trigger PVs (PC group, n = 76) or contact-force-guided PV isolation ablation alone (control group, n = 80)...
November 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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