Catheter-tissue contact force values do not impact mid-term clinical outcome following pulmonary vein isolation in patients with paroxysmal atrial fibrillation

  • Giuseppe Stabile
  • Francesco Solimene
  • Leonardo Calò
  • Matteo Anselmino
  • Antonello Castro
  • Claudio Pratola
  • Paolo Golia
  • Nicola Bottoni
  • Giuseppe Grandinetti
  • Antonio De Simone
  • Vincenzo Schillaci
  • Emanuele Bertaglia
  • Roberto De Ponti
Article

Abstract

Purpose

Catheter-tissue contact is critical for effective lesion creation in radiofrequency catheter ablation (RFCA). In a multicenter prospective study, we assessed the relationship between catheter contact force (CF) during RFCA for paroxysmal atrial fibrillation (AF) and clinical recurrences over a mid-term follow-up.

Methods

All patients underwent RFCA for paroxysmal AF by antral pulmonary vein (PV) isolation, aiming at entry and exit conduction block in all PVs. A new open-irrigated tip catheter with CF sensing (SmartTouchTM, Biosense Webster Inc. CA) was used. All patients were followed for at least 12 months and the relationship between CF and clinical outcomes assessed.

Results

One year follow-up was available in 92/95 of the patients enrolled. Acute PV isolation was achieved in 100 % of the veins. Mean CF during RFCA was 12.2 ± 3.9 g. Mean force-time integral (FTI) was 733 ± 505 gs. Following the 3-month blanking period, 17 (18 %) patients experienced at least 1 atrial tachyarrhythmia relapse. There was no statistical difference in mean CF (13 ± 3.4 g vs 12 ± 4 g, p = 0.32) and mean FTI (713 ± 487 gs vs 822 ± 590 gs, p = 0.42) between patients with and without arrhythmia recurrences. Recurrences were recorded in 22 % of patients achieving a mean FTI value below the median of 544 gs and in 15 % of patients with a mean FTI value above the median (p = 0.64).

Conclusions

RFCA with CF data during PV isolation for paroxysmal AF improves physician’s knowledge on catheter-tissue contact. In the present dataset, however, higher CF values did not impact mid-term clinical RFCA outcome.

Keywords

Catheter ablation Atrial fibrillation Contact force 

Notes

Conflict of interest

Dr. Roberto De Ponti is a consultant of Biosense Webster and Dr. Emanuele Bertaglia is a consultant of Biosense Webster, St. Jude Medical and Boston Scientific. There is no conflict of interest for the other authors.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Giuseppe Stabile
    • 1
  • Francesco Solimene
    • 2
  • Leonardo Calò
    • 3
  • Matteo Anselmino
    • 4
  • Antonello Castro
    • 5
  • Claudio Pratola
    • 6
  • Paolo Golia
    • 7
  • Nicola Bottoni
    • 8
  • Giuseppe Grandinetti
    • 9
  • Antonio De Simone
    • 10
  • Vincenzo Schillaci
    • 2
  • Emanuele Bertaglia
    • 11
  • Roberto De Ponti
    • 12
  1. 1.Laboratorio di ElettrofisiologiaClinica MediterraneaNaplesItaly
  2. 2.Clinica MontevergineMercoglianoItaly
  3. 3.Policlinico CasilinoRomeItaly
  4. 4.Città Della Salute e Della Scienza, Department of Medical SciencesUniversity of TurinTurinItaly
  5. 5.Ospedale Sandro PertiniRomeItaly
  6. 6.Ospedale Sant’AnnaFerraraItaly
  7. 7.Ospedale MorgagniForlìItaly
  8. 8.Azienda Ospedaliera Santa Maria NuovaReggio EmiliaItaly
  9. 9.Policlinico UniversitarioBariItaly
  10. 10.Clinica San MicheleMaddaloniItaly
  11. 11.Clinica Cardiologica, Dipartimento di Scienze Cardiologiche, Toraciche e VascolariUniversità di PadovaPadovaItaly
  12. 12.Ospedale di Circolo e Fondazione Macchi-University of InsubriaVareseItaly

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