Safety and efficiency of porous-tip contact-force catheter for drug-refractory symptomatic paroxysmal atrial fibrillation ablation: results from the SMART SF trial

Chinitz, Larry A.; Melby, Daniel P.; Marchlinski, Francis E.; Delaughter, Craig; Fishel, Robert S.; Monir, George; Patel, Ankit; Gibson, Douglas; Athill, Charles A.; Boo, Lee Ming; Stagg, Robert B.; Natale, Andrea

doi:10.1093/europace/eux264

Cited by 44 publications

(44 citation statements)

References 20 publications

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“…In the SMART‐SF trial, procedure features and fluid delivery by STSFc were observed in comparison to predecessor catheters from other registration trials. They found that average procedural times, fluoroscopic times and saline infusion volumes were significantly lower than reported in previous registration trials . In addition, Gonna et al, showed a reduced rate of primary composite endpoints of procedure failure and acute complications for STSFc in a matched pair analysis of STSFc as compared SFc .…”

Section: Discussionmentioning

confidence: 90%

“…This trial demonstrated that STSFc was safe and effective for AF ablation, with an acute PVI rate of up to 96.2%. However, the data suffers from lacking any long‐term follow‐up outcomes . Stabile et al reported a multicenter trial on the safety and efficacy of STSFc for patients with AF, wherein it was found that STSFc achieved a high rate of PVI (99%), and the procedural and fluoroscopic times were comparable with other catheters and with a low complication rate.…”

Section: Discussionmentioning

confidence: 99%

“…However, obtaining long‐term PVs electrical isolation remains challenging with just a single procedure . A lot of work has been made to develop ablation catheter with the intent of increasing long‐term efficacy and safety of AF ablation …”

Section: Introductionmentioning

confidence: 99%

“…4 A lot of work has been made to develop ablation catheter with the intent of increasing long-term efficacy and safety of AF ablation. [5][6][7][8] Open irrigation systems and contact force (CF) sensing represent two important landmarks in ablation catheterization technologies. 5 In recent years, CF-sensing catheters have been developed that can directly quantify tissue contact and provide real-time data to guide ablation.…”

Section: Introductionmentioning

confidence: 99%

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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: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…Particularly in the field of AF, these mapping systems have made the wide application of AF ablation possible [49]. Subsequent technical features such as measurement of the ablation catheter contact force and calculation of the force-time integral have recently been proposed as additional tools for the achievement of durable PVI [50][51][52][53][54]. Although some reports indicate a reduction of fluoroscopy time and radiation dose with the use of these features, their additive value [55], and in particular the additive benefit compared with conventional ablation techniques, still needs to be determined.…”

Section: Choice Of the Appropriate Techniquementioning

confidence: 99%

Catheter ablation of atrial fibrillation: current status, techniques, outcomes and challengesCatheter ablation of atrial fibrillation: current status, techniques, outcomes, and challenges

Hindricks¹,

Shamloo²,

Lenarczyk³

et al. 2018

Kardiol Pol

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Atrial fibrillation (AF) is the most common human arrhythmia. Interventional treatment with catheter ablation is an established technique that is increasingly applied and has become one of the main treatment modalities in patients with AF. Ablation results in significant improvement of symptoms and the quality of life. There is as yet no clear evidence of any impact of the procedure on hard clinical endpoints, except in patients with heart failure, who seem to benefit significantly from ablation. The cornerstone of the procedure is the achievement of pulmonary vein isolation. Radiofrequency energy is the main applied energy source, but cryoballoon ablation has emerged as a safe and effective alternative to radiofrequency ablation. Additional ablation strategies and novel technical features have been proposed but without unequivocal proof of clinical benefit. The most promising of these seems to be substrate mapping of the left atrium with substrate modification in areas with low voltage as an adjunct to pulmonary vein isolation. Complication rates remain considerable despite accumulated experience and can be partly reduced by application of preventive measures.

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Novel concepts in atrial fibrillation ablation—breaking the trade‐off between efficacy and safety

Althoff

Mont

2021

Journal of Arrhythmia

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Despite substantial technological and procedural advances that have improved the efficacy and safety of AF ablation in recent years, the long‐term durability of ablation lesions is still not satisfactory. There also remains concern regarding rare but potentially life‐threatening procedure‐related complications like cardiac tamponade and atrioesophageal fistulae. Current ablation strategies are aiming to optimize the trade‐off between efficacy and safety, where more extensive ablation appears to inevitably increase the risk of collateral injury. However, new forms of energy application may have the potential to resolve this quandary. The emerging concept of high power‐short duration radiofrequency ablation features a more favorable lesion geometry that appears ideally suited to create contiguous lesions in the thin‐walled atrium. Moreover, novel non‐thermal ablation methods based on electroporation appear to provide a unique selectivity for cardiomyocytes and to spare surrounding tissues composed of other cell types. Both, high power‐short duration and electroporation ablation might have the potential to break the trade‐off between effective lesions and collateral damage and to substantially improve risk‐benefit ratios in AF ablation. In addition, both approaches lead to considerable reductions in ablation times. However, their putative benefits regarding efficacy, efficiency, and safety remain to be proven in randomized controlled trials.

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Safety and efficiency of porous-tip contact-force catheter for drug-refractory symptomatic paroxysmal atrial fibrillation ablation: results from the SMART SF trial

Abstract: In the SMART-SF trial, the predetermined safety performance goal was met, demonstrating the safety and acute effectiveness of the THERMOCOOL SMARTTOUCH® SF Catheter for PAF ablation.

Cited by 44 publications

References 20 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

Catheter ablation of atrial fibrillation: current status, techniques, outcomes and challengesCatheter ablation of atrial fibrillation: current status, techniques, outcomes, and challenges

Novel concepts in atrial fibrillation ablation—breaking the trade‐off between efficacy and safety

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