Format

Send to

Choose Destination
See comment in PubMed Commons below
Heart Rhythm. 2014 Jun;11(6):984-91. doi: 10.1016/j.hrthm.2014.03.019. Epub 2014 Mar 18.

Comparison of lesion formation between contact force-guided and non-guided circumferential pulmonary vein isolation: a prospective, randomized study.

Author information

1
Department of Cardiology.
2
Department of Advanced Management of Cardiac Arrhythmias, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
3
Department of Cardiology. Electronic address: okumura@cc.hirosaki-u.ac.jp.

Abstract

BACKGROUND:

Contact force (CF) monitoring could be useful in accomplishing circumferential pulmonary vein (PV) isolation (CPVI) for atrial fibrillation (AF).

OBJECTIVE:

The purpose of this study was to compare procedure parameters and outcomes between CF-guided and non-guided CPVI.

METHODS:

Thirty-eight consecutive AF patients (mean age 60 ± 11 years, 28 paroxysmal AF) undergoing CPVI were randomized to non-CF-guided (n = 19) and CF-guided (n = 19) groups. CPVI was performed with the ThermoCool SmartTouch catheter in both groups. The end-point was bidirectional block between the left atrium (LA) and PV. In the CF group, CF was kept between 10 and 20 g during CPVI, whereas in the non-CF group, all CF information was blanked. Radiofrequency energy at 30 W in the anterior and 25 W in the posterior LA wall was applied for 20-25 seconds at each point.

RESULTS:

CPVI was successfully accomplished without any major complications in both groups. Mean CF in the non-CF and CF groups were 5.9 ± 4.5 g and 11.1 ± 4.3 g, respectively, for left-side CPVI, and 9.8 ± 6.6 g and 12.1 ± 4.8 g, respectively, for right-side CPVI (both P <.001). The procedure and fluoroscopy times for CPVI in the non-CF and CF groups were 96 ± 39 minutes and 59 ± 16 minutes, respectively (P <.001), and 22 ± 63 seconds and 9 ± 20 seconds (P = NS), respectively. Total number of residual conduction gaps was 6.3 ± 3.0 in the non-CF group and 2.8 ± 1.9 in the CF group (P <.001). During 6-month follow-up, 84.2% of patients in the non-CF group and 94.7% in the CF group were free from any atrial tachyarrhythmias (P = .34).

CONCLUSION:

CF-guided CPVI is effective in reducing procedure time and additional touch-up ablation and may improve long-term outcome.

KEYWORDS:

Atrial fibrillation; Catheter ablation; Computed tomography; Contact force; Fluoroscopy time; Pulmonary vein isolation

PMID:
24657428
DOI:
10.1016/j.hrthm.2014.03.019
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center