Advertisement

Should the force be with us?

Published:October 28, 2017DOI:https://doi.org/10.1016/j.hrthm.2017.10.040
      The goal of ablation is to create a continuous transmural lesion set that is facilitated by optimal catheter-tissue contact. Despite high acute procedural success for the main component of ablation of atrial fibrillation (AF)—pulmonary vein isolation (PVI)—outcomes are limited by recurrence largely fueled by lack of durable PVI. Contact force (CF) sensing (CFS) aims to optimize radiofrequency (RF) delivery by providing immediate feedback on catheter contact to improve lesion formation as well as reduce complications.
      • Yokoyama K.
      • Nakagawa H.
      • Shah D.C.
      • Lambert H.
      • Leo G.
      • Aeby N.
      • Ikeda A.
      • Pitha J.V.
      • Sharma T.
      • Lazzara R.
      • Jackman W.M.
      Novel contact force sensor incorporated in irrigated radiofrequency ablation catheter predicts lesion size and incidence of steam pop and thrombus.
      Early nonrandomized clinical studies
      • Natale A.
      • Reddy V.Y.
      • Monir G.
      • et al.
      Paroxysmal AF catheter ablation with a contact force sensing catheter: results of the prospective, multicenter SMART-AF trial.
      suggested improved efficacy, although differences in complication rates were elusive.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic and Personal
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Heart Rhythm
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Yokoyama K.
        • Nakagawa H.
        • Shah D.C.
        • Lambert H.
        • Leo G.
        • Aeby N.
        • Ikeda A.
        • Pitha J.V.
        • Sharma T.
        • Lazzara R.
        • Jackman W.M.
        Novel contact force sensor incorporated in irrigated radiofrequency ablation catheter predicts lesion size and incidence of steam pop and thrombus.
        Circ Arrhythm Electrophysiol. 2008; 1: 354-362
        • Natale A.
        • Reddy V.Y.
        • Monir G.
        • et al.
        Paroxysmal AF catheter ablation with a contact force sensing catheter: results of the prospective, multicenter SMART-AF trial.
        J Am Coll Cardiol. 2014; 64: 647-656
        • Nakamura K.
        • Naito S.
        • Sasaki T.
        • Nakano M.
        • Minami K.
        • Nakatani Y.
        • Ikeda K.
        • Yamashita E.
        • Kumagai K.
        • Funabashi N.
        • Oshima S.
        Randomized comparison of contact force-guided versus conventional circumferential pulmonary vein isolation of atrial fibrillation: prevalence, characteristics, and predictors of electrical reconnections and clinical outcomes.
        J Interv Card Electrophysiol. 2015; 44: 235-245
        • Kimura M.
        • Sasaki S.
        • Owada S.
        • Horiuchi D.
        • Sasaki K.
        • Itoh T.
        • Ishida Y.
        • Kinjo T.
        • Tomita H.
        • Okumura K.
        Comparison of lesion formation between contact force-guided and non-guided circumferential pulmonary vein isolation: a prospective, randomized study.
        Heart Rhythm. 2014; 11: 984-991
        • Pedrote A.
        • Arana-Rueda E.
        • Arce-León A.
        • Acosta J.
        • Gomez-Pulido F.
        • Martos-Maine J.L.
        • Frutos-Lopez M.
        • Sanchez-Brotons J.
        • Garcia-Reisco L.
        Impact of contact force monitoring in acute pulmonary vein isolation using an anatomic approach: a randomized study.
        Pacing Clin Electrophysiol. 2016; 39: 361-369
        • Ullah W.
        • McLean A.
        • Tayebjee M.H.
        • Gupta D.
        • Ginks M.R.
        • Haywood G.A.
        • O'Neill M.
        • Lambiase P.D.
        • Earley M.J.
        • Schilling R.J.
        Randomized trial comparing pulmonary vein isolation using the SmartTouch catheter with or without real-time contact force data.
        Heart Rhythm. 2016; 13: 1761-1767
        • Reddy V.Y.
        • Dukkipati S.R.
        • Neuzil P.
        • et al.
        Randomized, controlled trial of the safety and effectiveness of a contact force-sensing irrigated catheter for ablation of paroxysmal atrial fibrillation: results of the TactiCath Contact Force Ablation Catheter Study for Atrial Fibrillation (TOCCASTAR) Study.
        Circulation. 2015; 132: 907-915
        • Casella M.
        • Dello Russo A.
        • Russo E.
        • et al.
        Biomarkers of myocardial injury with different energy sources for atrial fibrillation catheter ablation.
        Cardiol J. 2014; 21: 516-523
        • Conti S.
        • Weerasooriya R.
        • Novak P.
        • Champagne J.
        • Euy Lim H.
        • Macle L.
        • Khaykin Y.
        • Pantano A.
        • Verma A.
        Contact force sensing for ablation of persistent atrial fibrillation: a randomized, multicenter trial.
        Heart Rhythm. 2018; 15: 201-208
        • Black-Maier E.
        • Pokorney S.D.
        • Barnett A.S.
        • Zeitler E.P.
        • Sun A.Y.
        • Jackson K.P.
        • Bahnson T.D.
        • Daubert J.P.
        • Piccini J.P.
        Risk of atrioesophageal fistula formation with contact force-sensing catheters.
        Heart Rhythm. 2017; 14: 1328-1333

      Linked Article