Abstract
Background: The clinical efficacy of catheter ablation of paroxysmal atrial fibrillation (AF) remains limited by difficulty in achieving durable pulmonary vein isolation (PVI). Suboptimal catheter tip-to-tissue contact force (CF) during lesion delivery is believed to reduce clinical efficacy. Objective: To determine the relationship between catheter CF during irrigated catheter ablation for AF and clinical recurrences during follow-up. Methods: Thirty-two patients with paroxysmal AF underwent PVI by using a radiofrequency ablation catheter with a CF sensor integrated at its tip, and they were followed for 12 months. The relationship between the CF and clinical outcomes was determined. Results: Acute PVI was achieved in 100% of the veins. Thirty-five percent (351 of 1017) of the applications were placed with an average CF of <10 g (low CF). All patients treated with an average CF of <10 g (5 of 5 patients) experienced recurrences, whereas 80% of the patients treated with an average CF of >20 g (8 of 10 patients) were free from AF recurrence at 12 months. The analysis of the average force-time integral showed that 75% of the patients treated with <500 gs were recurrent whereas only 31% of the patients treated with >1000 gs had recurrences at 12 months. Conclusions: The CF during catheter ablation for AF correlates with clinical outcome. Arrhythmia control is best achieved when ablation lesions are placed with an average CF of >20 g, and clinical failure is universally noted with an average CF of <10 g.
Original language | English |
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Pages (from-to) | 1789-1795 |
Number of pages | 7 |
Journal | Heart Rhythm |
Volume | 9 |
Issue number | 11 |
DOIs | |
State | Published - Nov 2012 |
Keywords
- Ablation
- Atrial fibrillation
- Catheter ablation
- Contact force
- Supraventricular tachycardia