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

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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.

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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.

Author information

Authors and Affiliations

  1. Laboratorio di Elettrofisiologia, Clinica Mediterranea, Via Orazio 2, 80122, Naples, Italy

    Giuseppe Stabile

  2. Clinica Montevergine, Mercogliano, AV, Italy

    Francesco Solimene & Vincenzo Schillaci

  3. Policlinico Casilino, Rome, Italy

    Leonardo Calò

  4. Città Della Salute e Della Scienza, Department of Medical Sciences, University of Turin, Turin, Italy

    Matteo Anselmino

  5. Ospedale Sandro Pertini, Rome, Italy

    Antonello Castro

  6. Ospedale Sant’Anna, Ferrara, Italy

    Claudio Pratola

  7. Ospedale Morgagni, Forlì, Italy

    Paolo Golia

  8. Azienda Ospedaliera Santa Maria Nuova, Reggio Emilia, Italy

    Nicola Bottoni

  9. Policlinico Universitario, Bari, Italy

    Giuseppe Grandinetti

  10. Clinica San Michele, Maddaloni, CE, Italy

    Antonio De Simone

  11. Clinica Cardiologica, Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Università di Padova, Padova, Italy

    Emanuele Bertaglia

  12. Ospedale di Circolo e Fondazione Macchi-University of Insubria, Varese, Italy

    Roberto De Ponti

Authors
  1. Giuseppe Stabile
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  2. Francesco Solimene
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  3. Leonardo Calò
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  4. Matteo Anselmino
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  5. Antonello Castro
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  6. Claudio Pratola
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  7. Paolo Golia
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  8. Nicola Bottoni
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  9. Giuseppe Grandinetti
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  10. Antonio De Simone
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  11. Vincenzo Schillaci
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  12. Emanuele Bertaglia
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  13. Roberto De Ponti
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Corresponding author

Correspondence to Giuseppe Stabile.

Appendix

Appendix

Participating centres (listed in alphabetical order):

Ospedale Sant’Anna, Ferrara (Matteo Bertini, Lina Marcantoni, Claudio Pratola); Ospedale Morgagni, Forlì (Alberto Bandini, Paolo Golia); Casa di Cura Montevergine, Mercogliano (Francesco Solimene, Giovanni Donnici); Casa di Cura Mediterranea, Napoli (Assunta Iuliano, Giuseppe Stabile); Policlinico Casilino, Roma (Leonardo Calò, Ermenegildo De Ruvo, Luigi Sciarra); Ospedale Sandro Pertini, Roma (Antonello Castro, Marialuisa Loricchio); Azienda Ospedaliera Santa Maria Nuova, Reggio Emilia (Nicola Bottoni, M Iori, F Quartieri); Città della Salute e della Scienza, Department of Medical Sciences, University of Turin (Matteo Anselmino, Federico Ferraris, Fiorenzo Gaita); Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese (Roberto De Ponti, Raffaella Marazzi, Lorenzo A Doni).

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Stabile, G., Solimene, F., Calò, L. et al. Catheter-tissue contact force values do not impact mid-term clinical outcome following pulmonary vein isolation in patients with paroxysmal atrial fibrillation. J Interv Card Electrophysiol 42, 21–26 (2015). https://doi.org/10.1007/s10840-014-9947-2

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  • DOI: https://doi.org/10.1007/s10840-014-9947-2

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