A major innovation in atrial fibrillation (AF) ablation has been the introduction of contact force (CF) sensing catheters.
To evaluate procedural and clinical effects of transitioning to CF-guided AF ablation.
Consecutive AF ablation patients were studiedduring the period of time of transitioning from a non-CF to CF sensing catheter. Procedural data recorded was total radiofrequency time, time to isolate the left pulmonary veins (LPVs), and time to isolate the right pulmonary veins (RPVs). Clinically, the 3 and 12-month maintenance of sinus rhythm was noted and compared by: paroxysmal vs. persistent AF; CT scan LA volume more or less than 150 cc; CHA2DS2VASC more or less than 2; and LVEF more or less than 55%. Safety data was recorded as well.
Total ablation times were shorter (113 vs.146 min, p=0.011)when using the CF catheters compared to non-CF ablations. This was driven by a decrease in both LPV (46 vs.72 min, p<0.001) and RPV time (54 vs. 75 min, p=0.002).The use of CF catheter did not change the overall percentage of patients in sinus rhythm at 3 and 12-months of follow up. However, sinus rhythm was more frequent at 12 months with CF ablation inpatients with an LA volume of more than 150 cc when compared to non-CF ablation (84.6% and 52.4%, p=0.03). There was no difference in outcomes with stratification by CHA2DS2VASC score or LVEF. No significant difference in complications was noted.
For AF ablation, the initial use of CF-sensing technology reduced procedure times with similar overall sinus rhythm maintenance at 3 and 12 months. CF improved 12-month outcomes in patients with an enlarged LA.
Credits: Daniel R. Frisch, Sean J. Dikdan