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Contact force ablation

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https://www.readbyqxmd.com/read/29345381/durable-lesion-formation-while-avoiding-esophageal-injury-during-ablation-of-atrial-fibrillation-lessons-learned-from-late-gadolinium-mr-imaging
#1
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
https://www.readbyqxmd.com/read/29326838/increasing-the-single-procedure-success-rate-of-pulmonary-vein-isolation
#2
Mattias Duytschaever, Mark O'Neill, Martin Martinek
To improve the single-procedural success and long-term outcomes of catheter ablation techniques for AF, there is a need for durable, contiguous and transmural lesions encircling the pulmonary veins (PV). Measurement of contact force (CF) between the catheter tip and the target tissue can optimise ablation procedures. A new approach to obtain single-procedure durable PV isolation (PVI) using the latest CF technology combined with the CARTO VISITAG™ Module with Ablation Index (Biosense Webster) has been shown in small studies to almost eliminate recurrence of paroxysmal AF at 1-year follow up and to make PVI procedures more reproducible...
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29325036/evaluation-of-left-atrial-linear-ablation-using-contiguous-and-optimized-radiofrequency-lesions-the-aline-study
#3
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
https://www.readbyqxmd.com/read/29315411/improving-procedural-and-one-year-outcome-after-contact-force-guided-pulmonary-vein-isolation-the-role-of-interlesion-distance-ablation-index-and-contact-force-variability-in-the-close-protocol
#4
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
https://www.readbyqxmd.com/read/29315382/safety-and-long-term-effectiveness-of-paroxysmal-atrial-fibrillation-ablation-with-a-contact-force-sensing-catheter-real-world-experience-from-a-prospective-multicentre-observational-cohort-registry
#5
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
https://www.readbyqxmd.com/read/29261126/remotely-exploring-deeper-into-matter-by-non-contact-detection-of-audible-transients-excited-by-laser-radiation
#6
Javier Moros, Inmaculada Gaona, J Javier Laserna
An acoustic spectroscopic approach to detect contents within different packaging, with substantially wider applicability than other currently available subsurface spectroscopies, is presented. A frequency-doubled Nd:YAG (neodymium-doped yttrium aluminum garnet) pulsed laser (13 ns pulse length) operated at 1 Hz was used to generate the sound field of a two-component system at a distance of 50 cm. The acoustic emission was captured using a unidirectional microphone and analyzed in the frequency domain. The focused laser pulse hitting the system, with intensity above that necessary to ablate the irradiated surface, transferred an impulsive force which led the structure to vibrate...
December 20, 2017: Sensors
https://www.readbyqxmd.com/read/29250289/mechanistic-insights-into-durable-pulmonary-vein-isolation-achieved-by-second-generation-cryoballoon-ablation
#7
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
https://www.readbyqxmd.com/read/29239758/efficacy-and-safety-comparison-between-different-types-of-novel-design-enhanced-open-irrigated-ablation-catheters-in-creating-cavo-tricuspid-isthmus-block
#8
Rikuta Hamaya, Shinsuke Miyazaki, Takatsugu Kajiyama, Tomonori Watanabe, Shigeki Kusa, Hiroaki Nakamura, Hitoshi Hachiya, Yoshito Iesaka
BACKGROUND: Clinical utility of irrigation-tip ablation catheters for cavo-tricuspid isthmus (CTI) ablation is established. Recently, new-generation enhanced-cooling irrigation-tip catheters were introduced into clinical use. This study compared the performance of different types of novel irrigation-tip catheters in CTI ablation. METHODS: One hundred patients undergoing CTI ablation with novel irrigated-tip catheters were included. Ablation was performed with a power output of 30-35W using either 4-mm flexible tip catheters [FlexAbility (FAs) St...
November 24, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29211857/pulmonary-vein-isolation-with-vs-without-continued-antiarrhythmic-drug-treatment-in-subjects-with-recurrent-atrial-fibrillation-powder-af-results-from-a-multicentre-randomized-trial
#9
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
https://www.readbyqxmd.com/read/29191055/recurrence-after-pulmonary-vein-isolation-is-associated-with-low-contact-force
#10
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...
November 30, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/29187667/strategy-and-outcome-of-catheter-ablation-for-persistent-atrial-fibrillation%C3%A3-impact-of-progress-in-the-mapping-and-ablation-technologies
#11
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...
November 30, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29171113/excessive-contact-force-can-overcome-irrigated-tip-catheter-benefits-during-atrial-fibrillation-ablation
#12
EDITORIAL
T Jared Bunch
No abstract text is available yet for this article.
November 24, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29161369/pace-capture-guided-ablation-after-contact-force-guided-pulmonary-vein-isolation-results-of-the-randomized-controlled-dragon-trial
#13
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
https://www.readbyqxmd.com/read/29116663/higher-contact-force-energy-setting-and-impedance-rise-during-radiofrequency-ablation-predicts-charring-new-insights-from-contact-force-guided-in-vivo-ablation
#14
Hisaki Makimoto, Andreas Metzner, Roland Richard Tilz, Tina Lin, Christian-H Heeger, Andreas Rillig, Shibu Mathew, Christine Lemeš, Erik Wissner, Karl-Heinz Kuck, Feifan Ouyang
INTRODUCTION: Higher contact force (CF) theoretically increases the risk of blood charring, diminishing lesion formation. We aimed to investigate the relationship between CF, impedance change and char formation during pulmonary vein isolation (PVI). METHODS: CF was assessed during PVI in 65 patients. Radiofrequency ablation (RFA) with power-controlled mode was applied in the point-by-point manner. The RFA were divided into 5 groups: group-A [CF < 10 g], group-B (10 g≤CF < 20 g), group-C (20 g≤CF < 30 g), group-D (30 g≤CF < 40 g), and group-E (CF≥40 g)...
November 8, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29110167/assessment-of-autonomic-nervous-system-modulation-after-novel-catheter-ablation-techniques-for-atrial-fibrillation-using-multiple-short-term-electrocardiogram-recordings
#15
Satoshi Yanagisawa, Yasuya Inden, Aya Fujii, Yosuke Kamikubo, Yasunori Kanzaki, Monami Ando, Junya Funabiki, Yosuke Murase, Masaki Takenaka, Noriaki Otake, Yoshihiro Ikai, Yusuke Sakamoto, Rei Shibata, Toyoaki Murohara
PURPOSE: The effect of novel catheter ablation techniques for atrial fibrillation (AF) on the autonomic nervous system (ANS) is unclear. This study aimed to assess the ANS after three novel catheter ablation techniques for paroxysmal AF by evaluating heart rate variability (HRV) parameters using a 3-min electrocardiogram recording. METHODS: Two hundred and thirty-five patients who underwent catheter ablation for paroxysmal AF (119 in irrigated-tip, 51 in contact-force sensing-guided, and 65 patients in second-generation cryoballoon ablation) were included...
November 6, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29102650/safety-and-feasibility-of-atrial-fibrillation-ablation-using-amigo-%C3%A2-system-versus-manual-approach-a-pilot-study
#16
Antonio Scarà, Luigi Sciarra, Ermenegildo De Ruvo, Alessio Borrelli, Domenico Grieco, Zefferino Palamà, Paolo Golia, Lucia De Luca, Marco Rebecchi, Leonardo Calò
BACKGROUND: The Amigo(®) Remote Catheter System is a relatively new robotic system for catheter navigation. This study compared feasibility and safety using Amigo (RCM) versus manual catheter manipulation (MCM) to treat paroxysmal atrial fibrillation (PAF). Contact force (CF) and force-time integral (FTI) values obtained during pulmonary vein isolation (PVI) ablation were compared. METHODS: Forty patients were randomly selected for either RCM (20) or MCM (20). All were studied with the Thermocool(®) SmartTouch(®) force-sensing catheter (STc)...
November 1, 2017: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/29071765/ablation-of-paroxysmal-atrial-fibrillation-using-a-2-nd-generation-cryoballoon-catheter-or-contact-force-sensing-radiofrequency-ablation-catheter-a-comparison-of-costs-and-long-term-clinical-outcomes
#17
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 2(nd) 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...
October 26, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29049540/feasibility-process-and-outcomes-of-cardiovascular-clinical-trial-data-sharing-a-reproduction-analysis-of-the-smart-af-trial
#18
Hawkins C Gay, Abigail S Baldridge, Mark D Huffman
Importance: Data sharing is as an expanding initiative for enhancing trust in the clinical research enterprise. Objective: To evaluate the feasibility, process, and outcomes of a reproduction analysis of the THERMOCOOL SMARTTOUCH Catheter for the Treatment of Symptomatic Paroxysmal Atrial Fibrillation (SMART-AF) trial using shared clinical trial data. Design, Setting, and Participants: A reproduction analysis of the SMART-AF trial was performed using the data sets, data dictionary, case report file, and statistical analysis plan from the original trial accessed through the Yale Open Data Access Project using the SAS Clinical Trials Data Transparency platform...
October 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29030237/contact-force-sensing-for-ablation-of-persistent-atrial-fibrillation-a-randomized-multicenter-trial
#19
Sergio Conti, Rukshen Weerasooriya, Paul Novak, Jean Champagne, Hong Euy Lim, Laurent Macle, Yaariv Khaykin, Alfredo Pantano, Atul Verma
BACKGROUND: Impact of contact force sensing (CFS) on ablation of persistent atrial fibrillation (PeAF) is unknown. OBJECTIVE: The purpose of the TOUCH AF (Therapeutic Outcomes Using Contact force Handling during Ablation of Persistent Atrial Fibrillation) randomized trial was to compare CFS-guided ablation to a CFS-blinded strategy. METHODS: Patients (n = 128) undergoing first-time ablation for persistent AF were randomized to a CFS-guided vs CFS-blinded strategy...
October 10, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29019873/reconstruction-left-atrium-and-isolation-pulmonary-veins-of-paroxysmal-atrial-fibrillation-using-single-contact-force-catheter-with-zero-x-ray-exposure-a-consort-study
#20
RANDOMIZED CONTROLLED TRIAL
Jian Qiang Zhang, Rong Hui Yu, Jia Bing Liang, De Yong Long, Cai Hua Sang, Chang Sheng Ma, Jian Zeng Dong
BACKGROUND: Conventional ablation of paroxysmal atrial fibrillation (PAF) is associated with radiation risks for patients and laboratory staff. Three-dimensional (3D) mapping system capable of showing contact force (CF) and direction of catheter tip may compensate for nonfluoroscopic safety issues. OBJECTIVE: The aim of this study was to investigate the feasibility of zero x-ray exposure during reconstruction left atrium (LA) and ablation. METHODS: Single, CF catheter, and 3D mapping system were used to reconstruct LA and isolate pulmonary veins (PV) in all patients...
October 2017: Medicine (Baltimore)
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