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Analysis of catheter contact force during atrial fibrillation ablation using the robotic navigation system: results from a randomized study

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

Contact with cardiac tissue is an important determinant of lesion efficacy during atrial fibrillation (AF) ablation. The Sensei X™ robotic navigation system (RNS) (Hansen Medical, Mountain View, CA, USA) has been validated for contact force (CF) sensing expressed in grams (g). The Thermocool® SmartTouch™ catheter enables the measurement of catheter tip CF and direction inside the heart. We aimed to investigate the catheter CF with and without RNS during pulmonary vein isolation (PVI) procedures.

Methods

Eighty patients with symptomatic AF (56 males, age 63 ± 18) were enrolled in this study. Fifty-seven patients had paroxysmal AF and 23 early persistent AF. All procedures were performed with the Thermocool® SmartTouch™ ablation catheter. Forty patients were randomized to perform PVI with the Sensei X™ RNS (group 1), while in the other 40 patients (group 2), PVI was performed without the RNS.

Results

AF ablation was performed successfully in all patients without complications, while contact force was kept in the established 10–40 g range. A significantly higher CF was documented on the PVs in group 1 compared to group 2. The 1-year freedom from AF recurrence was higher in group 1 compared to group 2 (90 vs. 65 %, p = 0.04). Moreover, a significant reduction of fluoroscopy time was noted in the RNS group (13 ± 10 vs. 20 ± 10 min, respectively, p = 0.05).

Conclusions

The Sensei X™ RNS permits a significantly higher CF during transcatheter AF ablation with a low rate of AF recurrence at clinical follow-up.

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Author information

Authors and Affiliations

  1. Cardiac Arrhythmia Research Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, Italy

    Antonio Dello Russo, Gaetano Fassini, Sergio Conti, Michela Casella, Eleonora Russo, Stefania Riva, Massimo Moltrasio, Fabrizio Tundo & Claudio Tondo

  2. Catholic University of Sacred Heart, Rome, Italy

    Antonio Di Monaco

  3. Casa di Cura Montevergine, Mercogliano, Italy

    Giuseppe De Martino

  4. Texas Cardiac Arrhythmia Institute at St David’s Medical Centre, Austin, TX, USA

    G. Joseph Gallinghouse, Luigi Di Biase, Andrea Natale & Claudio Tondo

  5. Albert Einstein College of Medicine at Montefiore Hospital, New York, NY, USA

    Luigi Di Biase

  6. Cardiology Department, University of Foggia, Foggia, Italy

    Luigi Di Biase

  7. Department of Biomedical Engineering, University of Texas, Austin, TX, USA

    Luigi Di Biase & Andrea Natale

  8. Division of Cardiology, Stanford University, Stanford, CA, USA

    Andrea Natale

  9. Case Western Reserve University, Cleveland, OH, USA

    Andrea Natale

  10. EP Services, California Pacific Medical Center, San Francisco, CA, USA

    Andrea Natale

  11. Interventional Electrophysiology, Scripps Clinic, San Diego, CA, USA

    Andrea Natale

Authors
  1. Antonio Dello Russo
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  2. Gaetano Fassini
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  3. Sergio Conti
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  4. Michela Casella
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  5. Antonio Di Monaco
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  6. Eleonora Russo
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  7. Stefania Riva
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  8. Massimo Moltrasio
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  9. Fabrizio Tundo
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  10. Giuseppe De Martino
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  11. G. Joseph Gallinghouse
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  12. Luigi Di Biase
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  13. Andrea Natale
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  14. Claudio Tondo
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Corresponding author

Correspondence to Sergio Conti.

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Dello Russo, A., Fassini, G., Conti, S. et al. Analysis of catheter contact force during atrial fibrillation ablation using the robotic navigation system: results from a randomized study. J Interv Card Electrophysiol 46, 97–103 (2016). https://doi.org/10.1007/s10840-016-0102-0

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  • DOI: https://doi.org/10.1007/s10840-016-0102-0

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