Impact of Contact Force Monitoring in Acute Pulmonary Vein Isolation Using an Anatomic Approach. A Randomized Study

Pacing and Clinical Electrophysiology : PACE
Alonso PedroteLorena García-Riesco

Abstract

The impact of contact force (CF) monitoring in pulmonary vein (PV) isolation after a circumferential anatomic ablation (CAA) is unknown. We analyze the usefulness of CF monitoring in acute PV isolation and procedure parameters using a CAA. Fifty patients with paroxysmal atrial fibrillation were randomized into CF-on (CF >10 grams; n = 25) or CF-off (CF blinded; n = 25) groups. We performed a first round of CAA with a ThermoCool(®) SmartTouch(®) catheter blinded to the LASSO(®) catheter (Biosense Webster, Diamond Bar, CA, USA), with radiofrequency (RF) lesions tagged with the VisiTag(™) Module. After the CAA, each PV was reviewed with the LASSO(®) catheter recording the segments with gaps. All the PVs were isolated with a CAA in 20 patients of the CF-on versus eight of the CF-off (P = 0.001). Of the 45 segments with gaps in the left PVs, 38 were from the CF-off (P = 0.0001). Of the eight segments with gaps in the right PVs, seven were from the CF-off (P = 0.06). The CF in the left PVs was higher in the CF-on (16.3 ± 3.2 grams vs 10.5 ± 4.3 grams; P = 0.0001) and similar in the right PVs (17.6 ± 3.6 grams vs 15.2 ± 5.3 grams; P = 0.08). All of the gaps were closed with additional RF LASSO(®) -guided touch-up. Procedure and fluoro...Continue Reading

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Citations

Jun 24, 2017·Journal of Cardiovascular Electrophysiology·Ahmed HusseinDhiraj Gupta
Oct 11, 2017·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·Larry A ChinitzAndrea Natale
Mar 27, 2019·Pacing and Clinical Electrophysiology : PACE·Alonso PedroteEduardo Arana-Rueda
Aug 23, 2019·Journal of Comparative Effectiveness Research·Peter J MallowJohn A Rizzo
Dec 14, 2018·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·Sohaib A VirkSaurabh Kumar
Aug 15, 2017·Annual Review of Medicine·Rakesh Latchamsetty, Fred Morady
Jun 23, 2018·JACC. Clinical Electrophysiology·Nilshan AriyarathnaGregory F Michaud

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