The importance of catheter stability evaluated by VisitagTM during pulmonary vein isolation

Fujiwara, Ryosuke; Imamura, Kimitake; Kijima, Yasufumi; Masano, Tomoya; Nagoshi, Ryoji; Kohzuki, Amane; Shibata, Hiroyuki; Tsukiyama, Yoshiro; Takeshige, Ryo; Yanaka, Kenichi; Nakano, Shinsuke; Fukuyama, Yoshikazu; Shite, Junya

doi:10.1007/s10840-016-0103-z

Cited by 13 publications

(6 citation statements)

References 23 publications

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“…However, a 66.3% successful rate of PVI at the initial procedure and a percentage of 77.5% freedom from atrial tachyarrhythmias at a 12-month follow-up in aforementioned studies might indicate suboptimal parameter settings for filters of the VisiTag™ module, respectively. In study by Fujiwara et al, although the ablation lesions with the acute conduction block was realized at a mean ablation time 12.5 s, the maximum value of FTI in these lesions was 213 g·s, which was almost half of an accepted reference value 400 g·s [ 10 ]. For these reasons, what is OPC for filters of the VisiTag™ module is still to be tested.…”

Section: Discussionmentioning

confidence: 99%

A Pilot Study on Parameter Setting of VisiTag™ Module during Pulmonary Vein Isolation

Wang

Huang

et al. 2018

Cardiology Research and Practice

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Objectives To identify optimal predefined criteria (OPC) for filters of the VisiTag™ module in the CARTO 3 system during pulmonary vein isolation (PVI). Methods Thirty patients with atrial fibrillation (AF) who experienced PVI first were enrolled. PVI was accomplished by using a Thermocool SmartTouch catheter. Ablation lesions were tagged automatically as soon as predefined criteria of the VisiTag™ module were met. OPC should be that ablation with the setting resulting in the conduction gap (CG) as few as possible, while contiguous encircling ablation line (CEAL) without the tag gap (TG) on the 3D anatomic model as much as possible. Result(s) When ablation with parameter setting is being catheter movement with a 3 mm distance limit for at least 20 s and force over time (FOT) being off, there were 60 CEAL without TG on the 3D anatomic model. However, 26 CGs were found. After changing FOT setting to be a minimal force of 5 g with 50% stability time, 22 TGs were displayed. Of them, 20 TGs were accompanied by CGs. On reablation at sites of TG with changed parameter setting, 18 CGs were eliminated when 20 TGs disappeared. When reablation with FOT is being a minimal force of 10 g with 50% stability time, 6 remaining CGs were eliminated. However, there was no CEAL. With a mean of follow-up 10.93 months, 2 patients with persistent AF suffered AF recurrence. Conclusion A 3 mm distance limit for at least 20 s and FOT being a minimal force of 5 g with 50% stability time might be OPC for the VisiTag™ module.

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Section: Discussionmentioning

confidence: 99%

A Pilot Study on Parameter Setting of VisiTag™ Module during Pulmonary Vein Isolation

Wang

Huang

et al. 2018

Cardiology Research and Practice

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“…The Bclock^of the time period of the VisiTag settings is continuously and sequentially reset. Thus, if only 1 VisiTag is marked on the 3D map during a span of 30 s, this indicates that the catheter tip has remained stable for 30 s. Together, our set CF maintained for a fairly low percentage of the time and the short time period will reduce the need [17]. Their setting comprised a distance of 1 mm, time of 5 s, and CF-over-time of 5 g over 25 % of the time with a lower FTI.…”

Section: Clinical Utility Of the Visitag Module For Eepvimentioning

confidence: 95%

Clinical utility of automated ablation lesion tagging based on catheter stability information (VisiTag Module of the CARTO 3 System) with contact force-time integral during pulmonary vein isolation for atrial fibrillation

Okumura

Watanabe

Iso

et al. 2016

J Interv Card Electrophysiol

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“…The safety improvements accompanying irrigated catheter designs resulted in a shift away from tissue temperature as the primary metric of effective lesion delivery. This catheter paradigm triggered iterative surrogates to facilitate feedback on energy transfer (i.e., contact force, stability), lesion durability (i.e., ablation index, lesion-size index), and procedural efficiency (i.e., high-power shortduration (HPSD), inter-lesion distance) [13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Characterizing lesion morphology of a novel diamond-tip temperature-controlled irrigated radiofrequency ablation catheter

Dhanjal

Schmidt

Getman

et al. 2023

J Interv Card Electrophysiol

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Background The DiamondTemp ablation (DTA) system is a novel temperature-controlled irrigated radiofrequency (RF) ablation system that accurately measures tip-tissue temperatures for real-time power modulation. Lesion morphologies from longer RF durations with the DTA system have not been previously described. We sought to evaluate lesion characteristics of the DTA system when varying the application durations. Methods A bench model using porcine myocardium was used to deliver discrete lesions in a simulated clinical environment. The DTA system was power-limited at 50 W with temperature set-points of 50 °C and 60 °C (denoted Group_50 and Group_60). Application durations were randomized with a range of 5–120 s. Results In total, 280 applications were performed. Steam pops were observed in five applications: two applications at 90 s and three applications at 120 s. Lesion size (depth and maximum width) increased significantly with longer applications, until 60 s for both Group_50 and Group_60 (depth: 4.5 ± 1.2 mm and 5.6 ± 1.3 mm; maximum width: 9.3 ± 2.7mm and 11.2 ± 1.7mm, respectively). As lesions transition from resistive to conductive heating (longer than 10 s), the maximum width progressed in a sub-surface propagation. Using a “Time after Temperature 60 °C” (TaT60) analysis, depths of 2–3 mm occur in 0–5 s and depths plateau at 4.6 ± 0.8 mm between 20 and 30 s. Conclusions The DTA system rapidly creates wide lesions with lesion depth increasing over time with application durations up to 60 s. Using a TaT60 approach is a promising ablation guidance that would benefit from further investigation.

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The importance of catheter stability evaluated by VisitagTM during pulmonary vein isolation

Abstract: Shorter ablation time recorded in Visitag lead to non-conduction blocking lesion.

Cited by 13 publications

References 23 publications

A Pilot Study on Parameter Setting of VisiTag™ Module during Pulmonary Vein Isolation

A Pilot Study on Parameter Setting of VisiTag™ Module during Pulmonary Vein Isolation

Clinical utility of automated ablation lesion tagging based on catheter stability information (VisiTag Module of the CARTO 3 System) with contact force-time integral during pulmonary vein isolation for atrial fibrillation

Characterizing lesion morphology of a novel diamond-tip temperature-controlled irrigated radiofrequency ablation catheter

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