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The importance of catheter stability evaluated by VisitagTM during pulmonary vein isolation

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

The recurrence rates of atrial fibrillation (Af) after ablation are still high, and repeat procedures are required in these patients. The main reason for Af recurrence is the recovery of the conduction between the pulmonary veins and left atrium. The importance of catheter stability during the pulmonary vein isolation (PVI) is not well studied.

Purpose

The purpose of this study was to evaluate the contact force (CF), stable ablation time, and power during conduction blocking lesion formation for PVI.

Methods

Thirty-two consecutive drug-refractory Af patients who underwent an initial PVI using CARTO 3 and Visitag were included. The CF, ablation time, force time integral (FTI), and ablation power were recorded by Visitag. Residual conduction gap points requiring touch-up ablation after an encircling linear ablation (R point), spontaneous reconnection points (S point), and dormant conduction points (D point) were considered as non-conduction blocking lesion points. Each ablation parameter for the non-conduction blocking lesion points was compared with the other lesion points.

Results

Twenty-one points in 16 patients were considered non-conduction blocking lesions. Ten were R, eight were S, and three were D points. The CF, ablation time, FTI, and power at the non-conduction blocking lesion points and other points were 12.0 g (7.0–21.5) and 12.0 g (9.0–16.0) (P = 0.9), 7.7 s (5.6–10.1) and 12.5 s (9.4–16.8) (P < 0.05), 103.0 g*s (62.0–174.5) and 149.0 g*s (104.0–213.0) (P < 0.05), and 30.0 W (22.5–30.0) and 30.0 W (30.0–30.0) (P = 0.06), respectively.

Conclusions

Shorter ablation time recorded in Visitag lead to non-conduction blocking lesion.

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Abbreviations

PV:

Pulmonary vein

Af:

Atrial fibrillation

PVI:

Pulmonary vein isolation

CF:

Contact force

FTI:

Force time integral

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Authors and Affiliations

  1. Department of Cardiology, Saiseikai Nakatsu Hospital, Shibata 2-10-39, Kita-ku, Osaka-shi, Osaka, 530-0012, Japan

    Ryudo Fujiwara, Kimitake Imamura, Yoichi Kijima, Tomoya Masano, Ryoji Nagoshi, Amane Kohzuki, Hiroyuki Shibata, Yoshiro Tsukiyama, Ryo Takeshige, Kenichi Yanaka, Shinsuke Nakano, Yusuke Fukuyama & Junya Shite

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  1. Ryudo Fujiwara
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  2. Kimitake Imamura
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  3. Yoichi Kijima
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Correspondence to Ryudo Fujiwara.

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Fujiwara, R., Imamura, K., Kijima, Y. et al. The importance of catheter stability evaluated by VisitagTM during pulmonary vein isolation. J Interv Card Electrophysiol 46, 161–166 (2016). https://doi.org/10.1007/s10840-016-0103-z

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  • DOI: https://doi.org/10.1007/s10840-016-0103-z

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