Real‐Time Contact Force Sensing for Pulmonary Vein Isolation in the Setting of Paroxysmal Atrial Fibrillation: Procedural and 1‐Year Results

Marijon, Éloi; Fazaa, S.; Narayanan, Kumar; Guy-Moyat, Benoît; Bouzeman, Abdeslam; Providência, Rui; Tréguer, F.; Combes, Nicolas; Bortone, Agustín; Boveda, Serge; Combes, Stéphane; Albenque, Jean‐Paul

doi:10.1111/jce.12303

Cited by 141 publications

(104 citation statements)

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“…[3][4][5] The use of contact force (CF)-sensing catheters, allowing to better control stability and lesion depth during point-by-point PV encircling, has improved freedom from AF now amounting to ≈80%. [6][7][8] Nevertheless, acute and late PVR still occur, and data on 1-year outcome are not consistent across studies. [6][7][8][9] We aimed to investigate whether acute and late PVR in CF-guided ablation are because of incomplete transmural or discontiguous radiofrequency lesions within the deployed PV circle and whether criteria can be set forward as targets to avoid weak links in the ablation chain.…”

mentioning

confidence: 99%

“…[6][7][8] Nevertheless, acute and late PVR still occur, and data on 1-year outcome are not consistent across studies. [6][7][8][9] We aimed to investigate whether acute and late PVR in CF-guided ablation are because of incomplete transmural or discontiguous radiofrequency lesions within the deployed PV circle and whether criteria can be set forward as targets to avoid weak links in the ablation chain. Criteria for lesion depth implied time of application, median delivered power, impedance drop, average CF, force-time integral (FTI), and ablation index (AI).…”

mentioning

confidence: 99%

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Determinants of Acute and Late Pulmonary Vein Reconnection in Contact Force–Guided Pulmonary Vein Isolation

Haddad

Taghji

Phlips

et al. 2017

Circ: Arrhythmia and Electrophysiology

149

101

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From August 2013, all patients undergoing CF-guided ablation for AF were followed in a prospective database approved by the local © 2017 American Heart Association, Inc. , and higher ILD max (6.8 versus 5.5 mm). ALCI min was significantly lower in segments with PVR (74% versus 104%; P˂0.001) and was associated with the highest accuracy to predict durable segments (area under the curve=0.73). Conclusions-In CF-guided pulmonary vein isolation, PVR is explained by lack of both lesion depth and contiguity within the deployed radiofrequency circle. ALCI, a novel measure combining contiguity and depth, is the most accurate predictor for durable segments. By avoiding weak links in the ablation chain, ALCI-guided ablation is expected to improve success rate of point-by-point radiofrequency ablation. (Circ Arrhythm Electrophysiol. 2017;10:e004867.

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mentioning

confidence: 99%

mentioning

confidence: 99%

Determinants of Acute and Late Pulmonary Vein Reconnection in Contact Force–Guided Pulmonary Vein Isolation

Haddad

Taghji

Phlips

et al. 2017

Circ: Arrhythmia and Electrophysiology

149

101

View full text Add to dashboard Cite

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“…A beavatkozás után 1 évvel a CF-RF csoport 76,5%-a, a CB-csoport 81%-a volt ritmuszavarmentes AAD nélkül, a legújabb nemzetközi közlemények is hasonló sikerarányról számolnak be [13][14][15]. A szövődményrátában tapasztalt különbségek nem jelentősek a két csoport között, mindkét módszer biztonságosnak mondható.…”

Section: Megbeszélésunclassified

“…Marijon és mtsai a CF-RF ablatiós katéter 1 éves utánkövetési adatait közöl-ték, kontrollcsoportként párhuzamba állították a technikát egy, a CF mérésére nem alkalmas irrigációs RF-katé-terrel. A CF-RF csoportban 89,5%-os sikerarányt tapasztaltak, szemben a kontrollcsoportban észlelt jóval alacsonyabb, 64,1%-os sikerrátánál [15]. A SMART-AF Trial prospektív, multicentrikus tanulmány során Natale és mtsai vizsgálták a CF-RF ablatiós katéter klinikai sikerességét.…”

Section: áBraunclassified

A paroxysmalis pitvarfibrilláció kezelésének transzkatéteres ablatiós technikái: új generációs krioballon vagy kontakterő-méréssel kombinált rádiófrekvenciás ablatio?

et al. 2016

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Bevezetés: A paroxysmalis pitvarfibrilláció eszközös kezelésében elterjedt a kontakterő-méréssel kombinált rádiófrek-venciás ablatio és az új generációs krioballonnal végzett ablatiós módszer. Célkitűzés: A szerzők célja, hogy összeha-sonlítsák a két ablatiós módszerrel kezelt betegek utánkövetési adatait. Módszer: Prospektív módon 96 (rádiófrekven-ciás ablatio: 58, krioballon: 38) beteg (65 férfi, 28-70 év) procedurális és 1 éves utánkövetési adatait elemezték. A beavatkozás után 1, 3, 6 és 12 hónappal EKG-, Holter-monitoros vizsgálat és ambuláns vizit történt. Eredmények: A procedúraidő és a sugáridő a két csoportban: rádiófrekvenciás ablatio: 118,5 ± 15 perc; 15,8 ± 6 perc; krioballon: 73,5 ± 16 perc (p<0,05); 13,8 ± 4,1 perc (p = 0,09) volt. A rádiófrekvenciás csoportban 76,5%, a krioballoncsoportban 81% volt az 1 éves sikerarány. A rádiófrekvenciás csoportban 1 esetben percutan punkcióval kezelhető pericardialis tamponád, a krioballoncsoportban 2 esetben átmeneti nervusphrenicus-bénulás történt. Következtetések: Primer pitvarfibrilláció ablatiót követően a két módszerrel hasonló 1 éves sikerarány érhető el, a krioballon alkalmazásakor szignifikánsan alacsonyabb procedúraidővel. Orv. Hetil., 2016, 157(22), 849-854. Kulcsszavak: pitvarfibrilláció, ablatio, rádiófrekvenciás ablatio, krioballonCatheter ablation for paroxysmal atrial fibrillation: new generation cryoballoon or contact force sensing radiofrequency ablation?Introduction: Contact force sensing radiofrequency ablation and the new generation cryoballoon ablation are prevalent techniques for the treatment of paroxysmal atrial fibrillation. Aim: The authors aimed to compare the procedural and 1-year outcome of patients after radiofrequency and cryoballoon ablation. Method: 96 patients with paroxysmal atrial fibrillation (radiofrequency ablation: 58, cryoballoon: 38 patients; 65 men and 31 women aged 28-70 years) were enrolled. At postprocedural 1, 3, 6 and 12 months ECG, Holter monitoring and telephone interviews were performed. Results: Procedure and fluorosocopy time were: radiofrequency ablation, 118.5 ± 15 min and 15.8 ± 6 min; cryoballoon, 73.5 ± 16 min (p<0.05) and 13.8 ± 4.,1 min (p = 0.09), respectively. One year later freedom from atrial fibrillation was achieved in 76.5% of patients who underwent radiofrequency ablation and in 81% of patients treated with cryoballoon. Temporary phrenic nerve palsy occurred in two patients and pericardial tamponade developed in one patient. Conclusions: In this single center study freedom from paroxysmal atrial fibrillation was similar in the two groups with significant shorter procedure time in the cryoballoon group.

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“…[9][10][11][12] Further, clinical outcomes have been reported to be superior in patients undergoing AF ablation with contact force catheters as compared with conventional ablation catheters. 13 The two main contact force catheters currently in use for AF ablation are the ThermoCool © SmartTOUCH™ catheter (Biosense Webster, CA, USA) and the TactiCath™ catheter (Endosense, Inc., Geneva, Switzerland).…”

Section: Advances In Catheter Design For Af Ablationmentioning

confidence: 99%

New Ablation Technologies and Techniques

Mahida

Berte

Yamashita

et al. 2014

Arrhythmia &Amp; Electrophysiology Review

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Since the first catheter ablation for cardiac arrhythmia more than three decades ago, ablation technology has continually evolved at a rapid pace. Much of the early progress in the field was made in ablation of supraventricular tachycardias. Following a seminal study from Haïssaguerre et al. 1 in 1998, which demonstrated that pulmonary vein triggers are important sources of atrial fibrillation (AF), the approach to management of AF underwent a revolution. Electrical isolation of pulmonary veins (PVs) using catheter ablation became an established therapeutic strategy in patients with paroxysmal AF. During subsequent years, the role of ablation in AF expanded, and more extensive strategies involving ablation of non-pulmonary vein triggers and modification of the left atrial substrate were demonstrated to be effective, even in persistent forms of AF. New Technologies and Techniques for AF AblationCurrently, the most widely used technique for PV isolation involves delivery of point-by-point ablation lesions around the circumference of the vein. A number of different variations to the approach have been developed. During the early stages of PV isolation, a 'segmental approach' which involved targeting the earliest PV potentials at the ostium of the PV was commonly used. Due to high reconnection rates and the risk of PV stenosis, the technique has progressively been modified and the prevailing technique involves circumferential antral ablation to achieve PV isolation. AbstractCatheter ablation is an established treatment strategy for a range of different cardiac arrhythmias. Over the past decade two major areas of expansion have been ablation of atrial fibrillation (AF) and ventricular tachycardia (VT) in the context of structurally abnormal hearts. In parallel with the expanding role of catheter ablation for AF and VT, multiple novel technologies have been developed which aim to increase safety and procedural success. Areas of development include novel catheter designs, novel navigation technologies and higher resolution imaging techniques. The aim of the present review is to provide an overview of novel developments in AF ablation and VT ablation in patients with of structural cardiac diseases.

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Real‐Time Contact Force Sensing for Pulmonary Vein Isolation in the Setting of Paroxysmal Atrial Fibrillation: Procedural and 1‐Year Results

Abstract: Our findings suggest a potential benefit of real-time CF sensing technology, in reducing AF recurrence during the first year after PVI.

Cited by 141 publications

References 30 publications

Determinants of Acute and Late Pulmonary Vein Reconnection in Contact Force–Guided Pulmonary Vein Isolation

Determinants of Acute and Late Pulmonary Vein Reconnection in Contact Force–Guided Pulmonary Vein Isolation

A paroxysmalis pitvarfibrilláció kezelésének transzkatéteres ablatiós technikái: új generációs krioballon vagy kontakterő-méréssel kombinált rádiófrekvenciás ablatio?

New Ablation Technologies and Techniques

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