Clin Res Cardiol 101, Suppl 1, April 2012

V1166 - Real Time Contact Force Measurement during AF Ablation Procedures - New Insights from a Single Center Experience
R. Wakili1, S. Clauß1, M. Ulbrich2, V. Schmidt1, F. V. Schüßler1, N. Oversohl1, A. Hahnefeld3, S. Kääb1, H. L. Estner1
1Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Campus Großhadern, München; 2Herzzentrum Siegburg, Klinik für Kardiologie, Angiologie, Helios Klinikum Siegburg GmbH, Siegburg; 3MVZ am Diako, Augsburg;
Introduction: Pulmonary vein isolation (PVI) is an established and highly used method to treat atrial fibrillation (AF). However, PVI is still a very time consuming procedure. Thus, new methods are necessary to improve procedural parameters, e.g. shortening of procedure duration. Ablation catheters providing real time contact force (RT CF) information are new tools trying to improve PVI procedures by generating more effective lesions. In this study we investigated the influence on procedural parameters by using the RT CF catheter Tacticath by Endosense©.
Methods: We performed an analysis on a total of 67 consecutive patients with paroxysmal (n=35) or persistent AF (n=32) undergoing PVI; patients were divided into 2 groups: 1.) n=32, ablation performed with Tacticath catheter (TC), and 2.) n=35, patients undergoing conventional ablation with a Biosense Thermocool© standard ablation catheter (SAC). Complete electrical isolation of all PVs was considered as procedural endpoint (PE). Study endpoints included left atrial (LA) procedure time for PVI, number of energy applications (60 sec. per application) needed to achieve PVI, absolute fall of impedance during first 10 seconds of every energy application serving as an index of lesion efficiency. We aimed for baseline force > 10 g and force time integral (FTI) of > 600 g/min in the TC group.
Results: Patient characteristics regarding percentage of paroxysmal AF, male gender, age, LA size, LV ejection fraction, history of hypertension or concomitant structural heart disease did not differ significantly between both groups. PE was reached in all patients. Application of RT CF measurement feature in the TC group did result in a significant reduction of LA procedure time (74.18 min. vs. 95.43 min., *p< 0.05, figure A), lower number of energy applications (35.56 vs. 45.89, *p< 0.05, figure B), and a greater/faster fall of impedance (8.76 Ω/10sec vs. 6.65 Ω/10sec, **p< 0.01, figure C) compared to the SAC group, suggesting a more efficient lesion creation by the RT CF catheter. Further analysis of contact force data revealed an average force of 17.4±1.04 g and a force time integral (FTI) of 713.35±44.64 per energy application.
Conclusions: Our results suggest a beneficial effect on procedural parameters by the use of RT CF in patients undergoing PVI for AF ablation, probably by creating more efficient lesions. However, further studies are still required to investigate the effect of RT CF on the long term outcome in regard to AF recurrence.



Clin Res Cardiol 101, Suppl 1, April 2012
Zitierung mit Vortrags- oder Posternummer s.o.
DOI 10.1007/s00392-012-1100-6