Role of contact force‐guided radiofrequency catheter ablation for treatment of atrial fibrillation: A systematic review and meta‐analysis

Lin, Hui; Chen, Yi-He; Hou, Jianwen; Lu, Zhao-Yang; Yin, Xiaoxing; Li, Yi‐Gang

doi:10.1111/jce.13264

Cited by 34 publications

(23 citation statements)

References 49 publications

(62 reference statements)

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“…CF is identified as a key determinant of lesion size, long term ablation efficacy and safety . A Lot's of observational studies have found overwhelming benefit from CF‐guided AF ablation, however a meta‐analysis of randomized data by Virk et al demonstrated that CF guidance does not improve the safety or efficacy of AF ablation . Even though, CF sensing technology in STc enables real‐time monitoring of CF between the catheter tip and tissues, and confirmed persistent appropriate pressure to effectively facilitate RF energy transfer to the tissue .…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of the ThermoCool SmartTouch SurroundFlow catheter for atrial fibrillation ablation: A meta‐analysis

Chen

Gao

Liu

et al. 2019

Clinical Cardiology

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Background The ThermoCool Smarttouch Surroundflow catheter (STSFc) is an advanced catheter, which integrating contact force sensing and surroundflow technology. However, comparative data between STSFc and contact force sensing catheter (Thermocool SmartTouch catheter [STc]) are limited. Hypothesis We thought that STSFc might bring more clinical benefits. The aim of this meta‐analysis was to compare the safety and efficiency between the STSFc and the STc for treatment of atrial fibrillation (AF). Methods The Medline, PubMed, Embase, and Cochrane Library databases were searched for studies comparing STSFc and STc. Results Four trials involving 727 patients were included in the study. Pool‐analyses demonstrated that, as compared STc ablation, STSFc ablation was more beneficial in terms of procedural times (standard mean difference [SMD]: −0.22; 95% confidence interval [CI], −0.37 to −0.07, P = .005) and irrigation fluid volume (SMD: −1.94; 95% CI, −2.65 to −1.22, P < .0001). There was no significant difference between STSFc and STc (risk ratio [RR]: 1.02; 95% CI: 0.86 to 1.21, P = .79) for free from AF. Evidence of complications were low and similar for both groups (RR: 0.83; 95% CI: 0.19‐3.55, P = .80). Additionally, patients administered STSFc ablation tended to have shorter fluoroscopic times (SMD: −0.20; 95% CI, −0.63‐0.23, P = .21). Conclusions STSFc ablation was associated with reducing procedural times and irrigation fluid volume. Further, STSFc ablation tended to shorten fluoroscopic times. Therefore, STSFc ablation would be a better choice for AF patients especially in patients with heart failure.

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of the ThermoCool SmartTouch SurroundFlow catheter for atrial fibrillation ablation: A meta‐analysis

Chen

Gao

Liu

et al. 2019

Clinical Cardiology

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“…The importance of CF in creating reliable lesions and improving safety during AF ablation is well documented. 7,10,[12][13][14][15] In the CF group, VT was induced during the procedure in 3 patients (CF value >20 g). In contrast, in the conventional group (in which impedance and temperature-but not CF-were monitored), the ablation procedure had to be suspended because of increasing impedance in 2 patients.…”

Section: Contact Force Value and Ablation Safetymentioning

confidence: 99%

“…Other studies in patients with AF showed that ablation with the CF-sensing catheter improved lesion size and depth and thus improved outcomes. 9,10 However, few studies have investigated the safety and effectiveness of the CF-sensing catheter when used for ablation of premature ventricular contractions (PVCs). 9,11 Therefore, we evaluated whether an irrigated CF-sensing catheter would improve the safety and effectiveness of RFCA of idiopathic PVCs originating from the right ventricular outflow tract (RVOT).…”

mentioning

confidence: 99%

Benefit of Contact Force–Guided Catheter Ablation for Treating Premature Ventricular Contractions

Zhao¹,

Liu²,

Gao³

et al. 2020

Texas Heart Institute Journal

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We evaluated whether an irrigated contact force–sensing catheter would improve the safety and effectiveness of radiofrequency ablation of premature ventricular contractions originating from the right ventricular outflow tract. We retrospectively reviewed the charts of patients with symptomatic premature ventricular contractions who underwent ablation with a contact force–sensing catheter (56 patients, SmartTouch) or conventional catheter (59 patients, ThermoCool) at our hospital from August 2013 through December 2015. During a mean follow-up of 16 ± 5 months, 3 patients in the conventional group had recurrences, compared with none in the contact force group. Complications occurred only in the conventional group (one steam pop; 2 ablations suspended because of significantly increasing impedance). In the contact force group, the median contact force during ablation was 10 g (interquartile range, 7–14 g). Times for overall procedure (36.9 ± 5 min), fluoroscopy (86.3 ± 22.7 s), and ablation (60.3 ± 21.4 s) were significantly shorter in the contact force group than in the conventional group (46.2 ± 6.2 min, 107.7 ± 30 s, and 88.7 ± 32.3 s, respectively; P <0.001). In the contact force group, cases with a force-time integral <560 gram-seconds (g-s) had significantly longer procedure and fluoroscopy times (both P <0.001) than did those with a force-time integral ≥560 g-s. These findings suggest that ablation of premature ventricular contractions originating from the right ventricular outflow tract with an irrigated contact force–sensing catheter instead of a conventional catheter shortens overall procedure, fluoroscopy, and ablation times without increasing risk of recurrence or complications.

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“…9 However, Lin et al performed a recent meta-analysis, demonstrating that this technology facilitates pulmonary vein isolation and results in more favorable outcomes and/or higher rates of AF-free survival without any increase in procedural-related complications. 10 In fact, the overall complication rate for AF ablation appears to be decreasing in comparison with that seen a decade ago. 11 When in doubt, we turn to data.…”

Section: Trouble In Paradisementioning

confidence: 99%

Posterior Wall Isolation for Atrial Fibrillation: Excessive or Necessary?

Doshi

2018

J Innov Cardiac Rhythm Manage.

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Role of contact force‐guided radiofrequency catheter ablation for treatment of atrial fibrillation: A systematic review and meta‐analysis

Cited by 34 publications

References 49 publications

Safety and efficacy of the ThermoCool SmartTouch SurroundFlow catheter for atrial fibrillation ablation: A meta‐analysis

Safety and efficacy of the ThermoCool SmartTouch SurroundFlow catheter for atrial fibrillation ablation: A meta‐analysis

Benefit of Contact Force–Guided Catheter Ablation for Treating Premature Ventricular Contractions

Posterior Wall Isolation for Atrial Fibrillation: Excessive or Necessary?

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