In vivocontact force measurements and correlation with left atrial anatomy during catheter ablation of atrial fibrillation

Abstract

Contact force during LA mapping significantly differs according to the location within the LA. These differences are independent of LA volume and anatomy of the PV ostia.

Optimal Force–Time Integral for Pulmonary Vein Isolation According to Anatomical Wall Thickness Under the Ablation Line

“…It has been reported that CF at the LLR tends to be low and that the majority of conduction gaps after single continuous circular lesions around ipsilateral PVs were located at the LLR and the anterior wall of the right PV . In the present study, the CF for the LLR was low, and most of the gaps and DCs were located at the LLR or the right anterior carina, which was consistent with previous reports . We speculate that the lower CF and insufficient FTI against the thick atrial walls at the LLR and anterior right PV wall led to the formation of gaps and DCs.…”

“…13 In the present study, the CF for the LLR was low, and most of the gaps and DCs were located at the LLR or the right anterior carina, which was consistent with previous reports. 12,13 We speculate that the lower CF and insufficient FTI against the thick atrial walls at the LLR and anterior right PV wall led to the formation of gaps and DCs. Although RF power is a known predictor of lesion size, 3,[14][15][16] it had no significant impact on gap or DC formation in this study.…”

“…A lower average CF has been reported as a strong predictor of gap formation. 6,10,11 It has been reported that CF at the LLR tends to be low 12 and that the majority of conduction gaps after single continuous circular lesions around ipsilateral PVs were located at the LLR and the anterior wall of the right PV. 13 In the present study, the CF for the LLR was low, and most of the gaps and DCs were located at the LLR or the right anterior carina, which was consistent with previous reports.…”

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

“…It is known that there are regions around the PV where gaps occur more frequently and where the CF means are lower . Schluermann et al . observed that the CF obtained in the left PVs are lower than in the right PVs and that the lowest values are in the anterior segments, where the narrow passage between the veins and the left atrial appendage is especially difficult.…”

Paroxysmal atrial fibrillation ablation: Achieving permanent pulmonary vein isolation by point-by-point radiofrequency lesions

“…This may explain the observation that PV reconnection tends to recur at specific regions in the LA. For example, Schluermann et al[23] reported lower CF obtained in left PVs than in right PVs and found the lowest values in the anterior segments, where the ridge between the left upper PV and the LA appendage represents anespecially challenging region for obtaining appropriate CF. Consistently with these data, our group observed that when operators were blinded to CF, the lowest CF values were recorded at the anterior segments of left PVs[24] (Figure 1).…”