Safety and long-term effectiveness of paroxysmal atrial fibrillation ablation with a contact force-sensing catheter: real-world experience from a prospective, multicentre observational cohort registry

Potter, Tom De; Herendael, Hugo Van; Balasubramaniam, Richard; Wright, Matthew; Agarwal, Sharad; Sanders, Prashanthan; Khaykin, Yaariv; Latcu, D.G.; Pani, Antonio; Hayes, John; Kalman, Jonathan M.; Nery, Pablo B.; Duncan, Edward

doi:10.1093/europace/eux290

Cited by 22 publications

(15 citation statements)

References 20 publications

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“…With regards to safety, our complication rate of 2.8% is in line with rates documented by other high and low volume centres worldwide (2.5−7.8%) with cardiac and vascular complications being more common than others [13] , [17] , [28] , [31] . Sairaku et al also demonstrated that low volume operators have higher major complication rates than high volume operators (7.8% vs 1.4%, p = 0.001) even though they only included pAF patients who underwent first PVI ablation with no adjunctive lines allowed [13] .…”

Section: Discussionsupporting

confidence: 89%

Catheter ablation for atrial fibrillation in a low-volume center using contemporary technology

Tay

Cai

Lin

et al. 2020

IJC Heart & Vasculature

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Highlights There has been significant heterogeneity in the definition of what constitutes as low volume operator /center for AF ablation. Current literature suggests lower success rates but higher complications rates in low-volume centers. First AF catheter ablation in a low-volume center has comparable safety and efficacy outcomes to high-volume centers using contemporary ablation technologies.

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Section: Discussionsupporting

confidence: 89%

Catheter ablation for atrial fibrillation in a low-volume center using contemporary technology

Tay

Cai

Lin

et al. 2020

IJC Heart & Vasculature

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“…Several studies found that ablation by SF technology significantly reduces ablation and fluoroscopic times, and early reconnection of PVs when compared with TCc . 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 .…”

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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“…Ablation strategies that target the pulmonary vein antra are the cornerstone for the majority of AF ablation procedures (3)(4)(5). Twice transseptal punctures with ablating and monitoring pulmonary venous potential simultaneously are commonly applied in the vast majority of cardiac electrophysiology centers (6,7). However, the traditional mapping and ablation techniques without real-time contact force sensing show poor efficiency on permanent transmural lesion formation and may lead to excessive X-ray exposure and procedure time.…”

Section: Introductionmentioning

confidence: 99%

Single transseptal puncture technique and contact force catheter: A simplified ablation strategy for paroxysmal atrial fibrillation

et al. 2020

Exp Ther Med

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The present study aimed to evaluate the safety and efficacy of an optimized single transseptal puncture technique and contact force sensing atrial fibrillation (AF) radiofrequency catheter ablation (RFCA) strategy within a clinical setting. Fast anatomic mapping and contact force sensing ablation was applied to patients with paroxysmal AF (PAF) ablation between September 2014 and December 2016 using a single trans-septal sheath. Pulmonary vein isolation (PVI) and linear ablation were performed in PAF individually with a 10-20 g contact force with minimal fluoroscopy. Stimulation with 10 mA outputs on the lesions without capture was used as endpoint. A total of 419 consecutive patients who underwent first-time RFCA were enrolled in the current study, and acute PVI was achieved in all patients. The average procedure time was 74.5±9.7 min, with an average ablation time of 27.3±7.8 min. The average fluoroscopy time was 4.7±3.3 min and the average radiation dose was 24.3±25.2 mGy. At a mean follow-up time of 14.5 ± 4.1 months, sinus rhythm was maintained at 85.0%. Cardiac tamponade occurred in one case. The results indicated that this simplified technique was a simple, safe and effective approach for PAF ablation therapy.

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Safety and long-term effectiveness of paroxysmal atrial fibrillation ablation with a contact force-sensing catheter: real-world experience from a prospective, multicentre observational cohort registry

Cited by 22 publications

References 20 publications

Catheter ablation for atrial fibrillation in a low-volume center using contemporary technology

Catheter ablation for atrial fibrillation in a low-volume center using contemporary technology

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

Single transseptal puncture technique and contact force catheter: A simplified ablation strategy for paroxysmal atrial fibrillation

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