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Higher contact-force values associated with better mid-term outcome of paroxysmal atrial fibrillation ablation using the SmartTouch™ catheter.
Europace. 2015 Jan; 17(1):56-63.E

Abstract

AIMS

Real-time measurement of contact force (CF) during catheter ablation of atrial fibrillation (AF) has been recently suggested to potentially impact procedural outcome. However, the role of CF intensity on mid-term results using the SmartTouch™ catheter has not been investigated so far.

METHODS AND RESULTS

Pulmonary vein isolation (PVI) using the SmartTouch™ catheter was performed in 100 eligible patients (age 62 ± 8; 79% men) undergoing a first procedure of paroxysmal AF catheter ablation. Continuous CF monitoring during catheter ablation allowed calculation of mean CF per patient. Patients were dichotomized into high CF (≥22 g, upper quartile) and low CF (<22 g, remaining) and enroled in a standardized follow-up programme (after a 3-month blanking period), free from antiarrhythmic therapy, with regular evaluations including 24 h Holter recordings at 1, 3, 6, 9, 12, 18, and 24 months. Atrial fibrillation relapse was defined as any symptomatic or asymptomatic atrial arrhythmia lasting >30 s. The average CF among all procedures was 19.6 ± 3.7 g. Though complete PVI was eventually achieved in all cases in both groups, success using an exclusively anatomical approach was higher in the high CF group (92.0 vs. 72.0%; P = 0.04). During a mean follow-up of 19 ± 5 months, a lower incidence of AF relapse was observed in higher CF patients (4.0 vs. 20.0%; log rank P = 0.04). Pericardial tamponade occurred in one patient in the higher CF group. No thromboembolism or procedure-associated deaths were observed.

CONCLUSION

Higher values of CF overall during antral PVI appear to be associated with a higher likelihood of sinus rhythm maintenance without significantly increasing the complication rate.

Authors+Show Affiliations

Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France rui_providencia@yahoo.com.European Georges Pompidou Hospital, Paris, France.Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.

Pub Type(s)

Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

25280910

Citation

Providência, Rui, et al. "Higher Contact-force Values Associated With Better Mid-term Outcome of Paroxysmal Atrial Fibrillation Ablation Using the SmartTouch™ Catheter." Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, vol. 17, no. 1, 2015, pp. 56-63.
Providência R, Marijon E, Combes S, et al. Higher contact-force values associated with better mid-term outcome of paroxysmal atrial fibrillation ablation using the SmartTouch™ catheter. Europace. 2015;17(1):56-63.
Providência, R., Marijon, E., Combes, S., Bouzeman, A., Jourda, F., Khoueiry, Z., Cardin, C., Combes, N., Boveda, S., & Albenque, J. P. (2015). Higher contact-force values associated with better mid-term outcome of paroxysmal atrial fibrillation ablation using the SmartTouch™ catheter. Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups On Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, 17(1), 56-63. https://doi.org/10.1093/europace/euu218
Providência R, et al. Higher Contact-force Values Associated With Better Mid-term Outcome of Paroxysmal Atrial Fibrillation Ablation Using the SmartTouch™ Catheter. Europace. 2015;17(1):56-63. PubMed PMID: 25280910.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Higher contact-force values associated with better mid-term outcome of paroxysmal atrial fibrillation ablation using the SmartTouch™ catheter. AU - Providência,Rui, AU - Marijon,Eloi, AU - Combes,Stéphane, AU - Bouzeman,Abdeslam, AU - Jourda,François, AU - Khoueiry,Ziad, AU - Cardin,Christelle, AU - Combes,Nicolas, AU - Boveda,Serge, AU - Albenque,Jean-Paul, Y1 - 2014/10/03/ PY - 2014/10/5/entrez PY - 2014/10/5/pubmed PY - 2015/9/9/medline KW - Arrhythmia KW - Catheter ablation KW - Contact-assisted ablation KW - Outcomes SP - 56 EP - 63 JF - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology JO - Europace VL - 17 IS - 1 N2 - AIMS: Real-time measurement of contact force (CF) during catheter ablation of atrial fibrillation (AF) has been recently suggested to potentially impact procedural outcome. However, the role of CF intensity on mid-term results using the SmartTouch™ catheter has not been investigated so far. METHODS AND RESULTS: Pulmonary vein isolation (PVI) using the SmartTouch™ catheter was performed in 100 eligible patients (age 62 ± 8; 79% men) undergoing a first procedure of paroxysmal AF catheter ablation. Continuous CF monitoring during catheter ablation allowed calculation of mean CF per patient. Patients were dichotomized into high CF (≥22 g, upper quartile) and low CF (<22 g, remaining) and enroled in a standardized follow-up programme (after a 3-month blanking period), free from antiarrhythmic therapy, with regular evaluations including 24 h Holter recordings at 1, 3, 6, 9, 12, 18, and 24 months. Atrial fibrillation relapse was defined as any symptomatic or asymptomatic atrial arrhythmia lasting >30 s. The average CF among all procedures was 19.6 ± 3.7 g. Though complete PVI was eventually achieved in all cases in both groups, success using an exclusively anatomical approach was higher in the high CF group (92.0 vs. 72.0%; P = 0.04). During a mean follow-up of 19 ± 5 months, a lower incidence of AF relapse was observed in higher CF patients (4.0 vs. 20.0%; log rank P = 0.04). Pericardial tamponade occurred in one patient in the higher CF group. No thromboembolism or procedure-associated deaths were observed. CONCLUSION: Higher values of CF overall during antral PVI appear to be associated with a higher likelihood of sinus rhythm maintenance without significantly increasing the complication rate. SN - 1532-2092 UR - https://www.unboundmedicine.com/medline/citation/25280910/Higher_contact_force_values_associated_with_better_mid_term_outcome_of_paroxysmal_atrial_fibrillation_ablation_using_the_SmartTouch™_catheter_ L2 - https://academic.oup.com/europace/article-lookup/doi/10.1093/europace/euu218 DB - PRIME DP - Unbound Medicine ER -