The symbiosis of contact force catheter use for hybrid ablation for atrial fibrillation

N. Kumar*, Laurent Pison, P. Lozekoot, R. Choudhury, M. La Meir, S. Gelsomino, H. Crijns, J. Maessen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Web of Science)

Abstract

Objective Reconduction across an ablation line is a common reason for arrhythmia recurrence over time. The hybrid procedure combines epicardial ablation of the pulmonary vein (PV) and creation of a box lesion with endocardial touch-ups for any electrical gaps. A high contact force (CF) between the ablation tip and cardiac tissue may increase the risk of thrombus formation, catheter tip charring, steam pop formation, and even cardiac perforation. CF monitoring is a significant new parameter for titration of the CF for creating an adequate lesion. Methods Thirty-eight consecutive patients underwent epicardial ablation using bipolar radiofrequency devices. After checking electrical bidirectional block of the ablation lines, an endocardial CF catheter was used for further ablation (if needed) to complete the isolation of PVs, box lesion, cavotricuspid isthmus (CTI), and complex fractionated atrial electrograms (CFAE). Results Endocardial touch-up was needed for 2 PVs (1.3 %) and 10 (26.3 %) box lesions. It was also used for the CTI line in 7 (18.4 %) patients, atrial tachycardia in 3 (7.9 %) patients, and additional CFAE ablation in 17 (44.7 %) patients. All 5 patients with arrhythmia recurrence had a mean CF <10 g (p = 0.03). Procedure duration was significantly shorter in the CF group (223 +/- 57 vs. 256 +/- 60 min, p = 0.03) compared with control group. Conclusion Use of CF catheters is safe, feasible, and complementary to a hybrid procedure setup for atrial fibrillation ablation. Its real-time monitoring may predict future arrhythmia recurrence, and decrease procedure time.
Original languageEnglish
Pages (from-to)438-444
JournalNetherlands Heart Journal
Volume23
Issue number9
DOIs
Publication statusPublished - Aug 2015

Keywords

  • Catheter ablation
  • Atrial fibrillation
  • Hybrid procedure
  • Contact force
  • Surgical ablation

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