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Persistent Atrial Fibrillation Ablation With or Without Contact Force Sensing
Author(s) -
HUSSEIN AYMAN A.,
BARAKAT AMR F.,
SALIBA WALID I.,
TARAKJI KHALDOUN G.,
BASSIOUNY MOHAMED,
BARANOWSKI BRYAN,
TCHOU PATRICK,
BHARGAVA MANDEEP,
DRESING THOMAS,
CALLAHAN THOMAS,
CANTILLON DANIEL,
KANJ MOHAMED,
LINDSAY BRUCE D.,
WAZNI OUSSAMA M.
Publication year - 2017
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.13179
Subject(s) - medicine , ablation , fluoroscopy , cardiology , atrial fibrillation , pulmonary vein , catheter ablation , confidence interval , hazard ratio , surgery
Contact Force Sensing for Persistent AF Ablation Introduction Arrhythmia recurrences remain common after ablation of persistent atrial fibrillation (PersAF). Contact force (CF)‐sensing catheters have been introduced for objective assessment of contact during radiofrequency application and have been suggested to improve outcomes in ablation of paroxysmal AF, but little is known about their role in PersAF ablation. We aimed to compare the procedural profiles and outcomes of (PersAF) ablation with or without using CF‐sensing catheters. Methods All consecutive patients undergoing first time ablation for PersAF between April 2014 and January 2015 at the Cleveland Clinic were included. Substrate modification was performed in addition to isolation of the pulmonary veins. Success rates were determined off antiarrhythmics over 1 year of follow‐up. Results The study included 174 patients (77 CF and 97 non‐CF). Ablation with CF‐sensing catheters resulted in shorter procedures (median 204 vs. 216 minutes, P = 0.04) and shorter fluoroscopy time (36 vs. 48 minutes, P = 0.0005), without statistical difference in radiation dose (225 vs. 270 milligrays, P = 0.1). Arrhythmia recurrences were less likely to be observed in the CF‐sensing group (27.6% vs. 46.4%, P = 0.01, log‐rank P = 0.004). In multivariable Cox analyses, the use of CF‐sensing catheters was associated with a lower risk of arrhythmia recurrence (hazard ratio 0.49, 95% confidence interval 0.27–0.85, P = 0.01). Conclusions Compared to non‐CF sensing, the use of CF‐sensing catheters for PersAF ablation is associated with shorter procedures, shorter fluoroscopy time, and reduction in arrhythmia recurrences.