RADIATION DOSE IS SIGNIFICANTLY REDUCED BY USE OF CONTACT FORCE SENSING CATHETER DURING CIRCUMFERENTIAL PULMONARY VEIN ISOLATION
K.A. Walsh, G.J. Fahy
Cardiology Department, Cardiorenal Centre, Cork University Hospital, Wilton, Cork City, Ireland
Purpose: Circumferential pulmonary vein isolation (CPVI) for treatment of atrial fibrillation involves significant radiation dose, ablation time and procedure time. We assessed the impact on these parameters of a radiofrequency ablation catheter (RFC) allowing contact force sensing (CFS) during CPVI.
Methods: Consecutive patients undergoing first CPVI under conscious sedation guided by Lasso®, CartoSound™, CartoMerge™ (MRI) and Fast Anatomical Mapping using the Carto 3 system (Biosense Webster Inc., Diamond Bar, CA) and steerable sheath (Agilis™NxT, St Jude Medical Inc., St Paul, MN) were included in this single centre, single operator study. RFC without CFS (Navistar™, Biosense Webster, Inc.) was used in the first 18 patients (Group 1). RFC with CFS (SmartTouch™, Biosense Webster, Inc.) was used in the subsequent 30 patients (Group 2). Ablation was applied at contact force > 9 g. The Mann Whitney U test was used to detect differences in radiation dose and fluoroscopy, ablation and procedure times.
Results: See Table. All pulmonary veins were isolated in all patients.
Conclusions: Contact force sensing allows significant reduction of radiation dose but does not shorten procedure time.
|
|
Age (Years)
|
Gender(male)
|
Fluoroscopy Time(mins)
|
X Ray Dose(cGy/cm2)
|
Procedure Time(mins)
|
Ablation Time(mins)
|
Paroxysmal(%)
|
| Group 1Navistar™ (n=18) |
52+/12 |
13 |
22.24 range (8.83-47.02) |
1782range (334-6342) |
180range (120-450) |
46 range (25-86) |
72.22 |
| Group 2 SmartTouch™ (n=30) |
52+/9 |
22 |
6.92range (1.17-27.33) |
473.25range (74.2-3734) |
203, range (120-345) |
56 range (37-109) |
63.34 |
| P value |
NS |
NS |
<0.001 |
<0.001 |
0.26 (NS) |
0.017 |
NS |
