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Contact force ablation

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https://www.readbyqxmd.com/read/29777548/higher-contact-force-during-radiofrequency-ablation-leads-to-a-much-larger-increase-in-edema-as-compared-to-chronic-lesion-size
#1
Samuel Thomas, Josh Silvernagel, Nathan Angel, Eugene Kholmovski, Elyar Ghafoori, Nan Hu, John Ashton, Derek J Dosdall, Rob MacLeod, Ravi Ranjan
INTRODUCTION: Reversible edema is a part of any radiofrequency ablation but its relationship with contact force is unknown. The goal of this study was to characterize through histology and MRI, acute and chronic ablation lesions and reversible edema with contact force. METHODS AND RESULTS: In a canine model (n = 14), chronic ventricular lesions were created with a 3.5 mm tip ThermoCool SmartTouch (Biosense Webster) catheter at 25W or 40W for 30 sec. Repeat ablation was performed after 3 months to create a second set of lesions (acute)...
May 18, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29777384/contribution-of-different-tarsal-attachment-devices-to-the-overall-attachment-ability-of-the-stink-bug-nezara-viridula
#2
Gianandrea Salerno, Manuela Rebora, Alexander Kovalev, Elena Gorb, Stanislav Gorb
The tarsal attachment devices of the southern green stink bug Nezara viridula, a cosmopolitan pest of different crops, encompass a pair of claws, distal pretarsal smooth pulvilli, and a proximal hairy pad on the ventral basitarsus. To evaluate the role of these attachment devices in generating attachment, behavioural experiments testing locomotion of insects with ablated pulvilli, shaved hairs and cut-off claws were performed. Using traction force experiments, insect attachment performance was evaluated on artificial substrates characterised by different roughness and on two substrates with different surface energies in the air and under water...
May 17, 2018: Journal of Comparative Physiology. A, Neuroethology, Sensory, Neural, and Behavioral Physiology
https://www.readbyqxmd.com/read/29759495/in-vitro-validation-of-the-lesion-size-index-to-predict-lesion-width-and-depth-after-irrigated-radiofrequency-ablation-in-a-porcine-model
#3
Vittorio Calzolari, Luca De Mattia, Stefano Indiani, Martino Crosato, Alberto Furlanetto, Claudia Licciardello, Paolo Antonio Maria Squasi, Zoran Olivari
OBJECTIVES: In an in vitro model, the authors tested the hypotheses that: 1) lesion dimensions correlate with lesion size index (LSI); and 2) LSI could predict lesion dimensions better than power, contact force (CF), and force-time integral (FTI). BACKGROUND: When performing radiofrequency (RF) catheter ablation for cardiac arrhythmias, reliable predictors of lesion quality are lacking. The LSI is a multiparametric index incorporating time, power, CF, and impedance recorded during ablation...
October 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759491/chamber-specific-radiofrequency-lesion-dimension-estimation-using-novel-catheter-based-tissue-interface-temperature-sensing-a-preclinical-assessment
#4
Jacob S Koruth, Jin Iwasawa, Yoshinari Enomoto, Meir Bar-Tal, Yigal Ultchin, Alona Sigal, Liron Mizrahi, Abraham Berger, Ori Hazan, Srinivas R Dukkipati, Vivek Y Reddy
OBJECTIVES: This study sought to compare a novel lesion dimension estimation approach to actual measurements of lesion dimensions on necropsy in porcine atria and ventricles. BACKGROUND: An irrigated-tip, force-sensing radiofrequency catheter with 6 temperature (tip-tissue interface) sensors allows for assessment of lesion dimensions based on estimated tissue temperature. Lesion dimension assessment has not been attempted previously in atrial tissue. METHODS: Ablations were performed using this catheter in all chambers...
October 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759489/ablation-index-and-surround-flow-catheter-irrigation-impedance-based-appraisal-in-clinical-ablation
#5
Waqas Ullah, Ross J Hunter, Malcolm C Finlay, Ailsa McLean, Mehul B Dhinoja, Simon Sporton, Mark J Earley, Richard J Schilling
OBJECTIVES: This study sought to assess the impact of ablation power and catheter irrigation during clinical radiofrequency ablation using impedance drop. BACKGROUND: In preclinical studies, ablation power and catheter irrigation are determinants of ablation efficacy. METHODS: Static 30-s left atrial ablations were delivered in patients undergoing their first atrial fibrillation ablation. Impedance drop during ablation (as a measure of efficacy) was compared using the following: the force time integral (FTI); the FTI-P (a cumulative multiple FTI and ablation power), and ablation index (AI), a weighted algorithm including contact force, power, and duration...
October 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759434/pulmonary-vein-re-isolation-as-a-routine-strategy-regardless-of-symptoms-the-pressure-randomized-controlled-trial
#6
Moloy Das, Gareth J Wynn, Yawer Saeed, Sean Gomes, Maureen Morgan, Christina Ronayne, Laura J Bonnett, Johan E P Waktare, Derick M Todd, Mark C S Hall, Richard L Snowdon, Simon Modi, Dhiraj Gupta
OBJECTIVES: The goal of this study was to determine whether a strategy of early re-isolation of pulmonary vein (PV) reconnection in all patients, regardless of symptoms, would reduce the recurrence of atrial fibrillation (AF) and improve quality of life. BACKGROUND: Lasting pulmonary vein isolation (PVI) remains elusive. PV reconnection is strongly linked to the recurrence of arrhythmia. METHODS: A total of 80 patients with paroxysmal AF were randomized 1:1 after contact force-guided PVI to receive either standard care or undergo a repeat electrophysiology study after 2 months regardless of symptoms (repeat study)...
June 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29740700/the-best-of-two-worlds-pulmonary-vein-isolation-using-a-novel-radiofrequency-ablation-catheter-incorporating-contact-force-sensing-technology-and-56-hole-porous-tip-irrigation
#7
Tilman Maurer, Laura Rottner, Hisaki Makimoto, Bruno Reissmann, Christian-H Heeger, Christine Lemes, Thomas Fink, Johannes Riedl, Francesco Santoro, Peter Wohlmuth, Marius Volkmer, Shibu Mathew, Andreas Metzner, Feifan Ouyang, Karl-Heinz Kuck, Christian Sohns
AIMS: This study aimed to evaluate feasibility and safety as well as 1-year clinical outcome of pulmonary vein isolation (PVI) using a unique radiofrequency ablation catheter ("Thermocool SmartTouch SurroundFlow"; STSF) incorporating both, contact force (CF) sensing technology and enhanced tip irrigation with 56 holes, in one device. METHODS: A total of 110 patients suffering from drug-refractory atrial fibrillation underwent wide area circumferential PVI using either the STSF ablation catheter (75 consecutive patients, study group) or a CF catheter with conventional tip irrigation ("Thermocool SmartTouch", 35 consecutive patients, control group)...
May 8, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29724033/force-trends-and-pulsatility-for-catheter-contact-identification-in-intracardiac-electrograms-during-arrhythmia-ablation
#8
David Rivas-Lalaleo, Sergio Muñoz-Romero, Mónica Huerta, Mayra Erazo-Rodas, Juan José Sánchez-Muñoz, José Luis Rojo-Álvarez, Arcadi García-Alberola
The intracardiac electrical activation maps are commonly used as a guide in the ablation of cardiac arrhythmias. The use of catheters with force sensors has been proposed in order to know if the electrode is in contact with the tissue during the registration of intracardiac electrograms (EGM). Although threshold criteria on force signals are often used to determine the catheter contact, this may be a limited criterion due to the complexity of the heart dynamics and cardiac vorticity. The present paper is devoted to determining the criteria and force signal profiles that guarantee the contact of the electrode with the tissue...
May 2, 2018: Sensors
https://www.readbyqxmd.com/read/29722859/contact-force-with-magnetic-guided-catheter-ablation
#9
Francis Bessière, Christopher Zikry, Lena Rivard, Katia Dyrda, Paul Khairy
Aims: Achieving adequate catheter tip-tissue contact is essential for delivering robust radiofrequency (RF) ablation lesions. We measured the contact force generated by a remote magnetic-guided catheter navigation system. Methods and results: A plexiglass model with an integrated scale was fashioned to mimic transvenous and retrograde access to sites in the right atrium and right and left ventricles. An 8 Fr RF ablation catheter was steered by remote magnetic guidance at fields of 0...
May 1, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29722857/procedural-and-long-term-outcome-after-catheter-ablation-of-idiopathic-outflow-tract-ventricular-arrhythmias-comparing-manual-contact-force-and-magnetic-navigated-ablation
#10
Lennart J de Vries, Astrid A Hendriks, Sing C Yap, Dominic A M J Theuns, Ron T van Domburg, Tamas Szili-Torok
Aims: Currently, comparative data on procedural and long-term clinical outcome of outflow tract (OT) idiopathic ventricular arrhythmia (IVA) ablation with manual (MAN), contact force (CF), and magnetic navigation system (MNS) ablation are lacking. The aim of this study was to compare the procedural and long-term clinical outcome of MAN, CF, and MNS ablation of OT IVAs. Methods and results: Seventy-three patients (31 MAN, 17 CF, and 25 MNS patients; consecutive per group) with OT IVA, who underwent catheter ablation in our centre were analysed...
May 1, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29701778/voltage-and-pace-capture-mapping-of-linear-ablation-lesions-overestimates-chronic-ablation-gap-size
#11
Louisa O'Neill, James Harrison, Henry Chubb, John Whitaker, Rahul K Mukherjee, Lars Ølgaard Bloch, Niels Peter Andersen, Høgni Dam, Henrik K Jensen, Steven Niederer, Matthew Wright, Mark O'Neill, Steven E Williams
Aims: Conducting gaps in lesion sets are a major reason for failure of ablation procedures. Voltage mapping and pace-capture have been proposed for intra-procedural identification of gaps. We aimed to compare gap size measured acutely and chronically post-ablation to macroscopic gap size in a porcine model. Methods and results: Intercaval linear ablation was performed in eight Göttingen minipigs with a deliberate gap of ∼5 mm left in the ablation line. Gap size was measured by interpolating ablation contact force values between ablation tags and thresholding at a low force cut-off of 5 g...
April 26, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29671105/mapping-and-ablation-of-rvot-type-arrhythmias-comparison-between-the-conventional-and-reversed-u-curve-methods
#12
Zhuo Liang, Xuejun Ren, Tao Zhang, Zhihong Han, Jianzeng Dong, Yunlong Wang
PURPOSE: We assessed conventional and reversed U curve methods for mapping and ablation of RVOT-type VAs. METHODS: Single-center data were reviewed from consecutive cases of symptomatic VAs of RVOT-type origin that were mapped and ablated successfully using conventional method in RVOT (pulmonary artery might be included) from January 2014 to December 2015 (cohort 1, n = 75) or conventional method in RVOT and reversed U curve in PSC (for first ablation attempt) from January 2016 to March 2017 (cohort 2, n = 60)...
June 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29657597/successful-catheter-ablation-of-ventricular-premature-complexes-from-the-right-atrial-side-of-the-atrioventricular-septum-with-good-contact-force
#13
Marina Arai, Seiji Fukamizu, Iwanari Kawamura, Satoshi Miyazawa, Rintaro Hojo, Harumizu Sakurada, Masayasu Hiraoka
The acquisition of good contact force for radiofrequency catheter ablation of ventricular premature complexes (VPCs) originating from the basal septum of the left ventricle (LV) is often difficult. We describe a case of VPCs originating from the basal septum of the LV, which were successfully eliminated by applying radiofrequency at the right atrium (RA) side of the atrioventricular septum (AVS) without causing any significant impairment of atrioventricular conduction because the ablation catheter could obtain better contact force through the RA approach...
April 2018: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29653251/probabilistic-guidance-for-catheter-tip-motion-in-cardiac-ablation-procedures
#14
Mihaela Am Constantinescu, Su-Lin Lee, Sabine Ernst, Apit Hemakom, Danilo Mandic, Guang-Zhong Yang
Radiofrequency catheter ablation is one of the commonly available therapeutic methods for patients suffering from cardiac arrhythmias. The prerequisite of successful ablation is sufficient energy delivery at the target site. However, cardiac and respiratory motion, coupled with endocardial irregularities, can cause catheter drift and dispersion of the radiofrequency energy, thus prolonging procedure time, damaging adjacent tissue, and leading to electrical reconnection of temporarily ablated regions. Therefore, positional accuracy and stability of the catheter tip during energy delivery is of great importance for the outcome of the procedure...
March 23, 2018: Medical Image Analysis
https://www.readbyqxmd.com/read/29618475/novel-measure-of-local-impedance-predicts-catheter-tissue-contact-and-lesion-formation
#15
Matthew S Sulkin, Jacob I Laughner, Sebastian Hilbert, Suraj Kapa, Jedrzej Kosiuk, Paul Younan, Iñaki Romero, Allan Shuros, Jason J Hamann, Gerhard Hindricks, Andreas Bollmann
BACKGROUND: Coupling between the ablation catheter and myocardium is critical to resistively heat tissue with radiofrequency ablation. The objective of this study was to evaluate whether a novel local impedance (LI) measurement on an ablation catheter identifies catheter-tissue coupling and is predictive of lesion formation. METHODS AND RESULTS: LI was studied in explanted hearts (n=10 swine) and in vivo (n=10; 50-70 kg swine) using an investigational electroanatomic mapping system that measures impedance from an ablation catheter with mini-electrodes incorporated in the distal electrode (Rhythmia and IntellaNav MiFi OI, Boston Scientific)...
April 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29603755/impact-of-left-atrial-size-on-isolation-area-in-the-acute-phase-of-pulmonary-vein-isolation-using-28-mm-cryoballoon
#16
Akio Chikata, Takeshi Kato, Kazuo Usuda, Shuhei Fujita, Michiro Maruyama, Yoshiki Nagata, Satoru Sakagami, Naomi Kanamori, Takanori Yaegashi, Takahiro Saeki, Takashi Kusayama, Soichiro Usui, Hiroshi Furusho, Shuichi Kaneko, Masayuki Takamura
BACKGROUND: The impact of left atrial (LA) size on isolation area (ISA) using a 28-mm second-generation cryoballoon (CB) in the acute phase after pulmonary vein isolation (PVI) and the differences of CB from contact force-guided radiofrequency (RF) ablation have not been fully investigated. METHODS: We examined 85 consecutive patients (CB group, 35; RF group, 50) with drug-refractory paroxysmal atrial fibrillation who underwent their first PVI procedure at two institutions...
March 31, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29600792/evaluation-of-a-strategy-aiming-to-enclose-the-pulmonary-veins-with-contiguous-and-optimized-radiofrequency-lesions-in-paroxysmal-atrial-fibrillation-a-pilot-study
#17
Philippe Taghji, Milad El Haddad, Thomas Phlips, Michael Wolf, Sebastien Knecht, Yves Vandekerckhove, Rene Tavernier, Hiroshi Nakagawa, Mattias Duytschaever
OBJECTIVES: This study sought to evaluate the safety and the acute and 1 year outcomes of an ablation protocol aiming to enclose the PV with a contiguous and optimized RF circle by targeting region-specific criteria for lesion depth assessed by ablation index and interlesion distance. BACKGROUND: Reconnections after pulmonary vein (PV) isolation are explained by insufficient lesion depth and/or discontiguity of radiofrequency (RF) lesions. METHODS: A total of 130 consecutive patients with paroxysmal atrial fibrillation (AF) underwent PV encircling using a contact force-sensing catheter...
January 2018: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29572086/influence-of-contact-force-on-voltage-mapping-a-combined-magnetic-resonance-imaging-and-electroanatomic-mapping-study-in-patients-with-tetralogy-of-fallot
#18
Elvis Teijeira-Fernandez, Hubert Cochet, Felix Bourier, Masateru Takigawa, Ghassen Cheniti, Nathaniel Thompson, Antonio Frontera, Claudia Camaioni, Gregoire Massouille, Zakaria Jalal, Nicolas Derval, Xavier Iriart, Arnaud Denis, Meleze Hocini, Michel Haissaguerre, Pierre Jais, Jean-Benoit Thambo, Frederic Sacher
BACKGROUND: Voltage criteria for ventricular mapping have been obtained from small series of patients and prioritizing high specificity. OBJECTIVE: Using tetralogy of Fallot as a model of transmural right ventricular (RV) scar and MRI as reference, we aimed to study the potential influence of contact force (CF) on voltage mapping and to define voltage cutoff values for RV scar. METHODS: Fourteen patients (age 32.6±14.3, 5 female) with repaired tetralogy of Fallot underwent high resolution cardiac MRI (1...
March 20, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29505684/accuracy-of-left-atrial-bipolar-voltages-obtained-by-confidense-multielectrode-mapping-in-patients-with-persistent-atrial-fibrillation
#19
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 multielectrode (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
https://www.readbyqxmd.com/read/29500567/contact-force-facilitates-the-achievement-of-an-unexcitable-ablation-line-during-pulmonary-vein-isolation
#20
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
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