Background
Objective
Methods
Results
Conclusion
Graphical abstract

Keywords
Introduction
Methods
Patient selection and computed tomography scanning

Reddy VY, Dukkipati SR, 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. Circulation2015;132:907–915.
Ablation procedure
Reddy VY, Dukkipati SR, 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. Circulation2015;132:907–915.

3D measurement method of the PV ostium
Callieri M, Cignoni P, Dellepiane M, Ranzuglia G, Scopigno R. Processing a complex architectural sampling with Meshlab: the case of Piazza Della Signoria. In: 4th Isprs International Workshop 3D-ARCH 2011: 3D Virtual Reconstruction and Visualization of Complex Architectures. vol XXXVIII-5/W16. ISPRS (International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences). 2011:205–212.
Statistical analysis
Results
Patient selection and demographic characteristics
Characteristic | Total cohort | PFA | RFA | P |
---|---|---|---|---|
(N = 80) | (n = 37) | (n = 43) | ||
Age (y) | 60.5 ± 9.8 | 58.9 ± 10.1 | 61.9 ± 9.4 | .171 |
Male sex | 59 (73.8) | 28 (75.7) | 31 (72.1) | .717 |
Hypertension | 43 (53.8) | 23 (62.2) | 20 (46.5) | .162 |
Diabetes | 6 (7.5) | 4 (10.8) | 2 (4.7) | .269 |
Stroke or TIA | 5 (6.3) | 2 (5.4) | 3 (7.0) | .572 |
CAD (MI or CABG) | 6 (7.5) | 0 (0.0) | 6 (14.0) | .020 |
LVEF (%) | 61.6 ± 5.0 | 63.0 ± 3.4 | 60.4 ± 5.8 | .017 |
LA diameter (mm) | 39.5 ± 6.0 | 41.2 ± 3.9 | 37.9 ± 7.0 | .010 |
Days to CT scan | 105 ± 38 | 108 ± 48 | 101 ± 27 | .436 |
Changes in PV diameters
Variable | Axis | PFA | P | RFA | |||||
---|---|---|---|---|---|---|---|---|---|
N | Pre | Post | n | Pre | Post | P | |||
RSPV | Long | 32 | 21.0 ± 3.6 | 21.0 ± 3.7 | .844 | 43 | 20.0 ± 2.8 | 18.8 ± 3.2 | .001 |
Short | 19.2 ± 3.9 | 19.6 ± 4.0 | .216 | 18.4 ± 3.6 | 16.3 ± 3.6 | <.001 | |||
RIPV | Long | 36 | 19.9 ± 2.7 | 19.7 ± 2.9 | .645 | 43 | 18.6 ± 3.7 | 17.6 ± 4.1 | .005 |
Short | 17.6 ± 3.4 | 18.3 ± 3.3 | .046 | 16.7 ± 3.4 | 15.3 ± 3.4 | <.001 | |||
LSPV | Long | 28 | 22.1 ± 2.7 | 22.4 ± 2.8 | .317 | 37 | 20.4 ± 3.2 | 16.8 ± 4.5 | <.001 |
Short | 15.9 ± 2.5 | 16.1 ± 3.1 | .532 | 13.9 ± 3.2 | 11.4 ± 3.7 | <.001 | |||
LIPV | Long | 31 | 17.6 ± 2.8 | 17.9 ± 2.7 | .245 | 37 | 17.0 ± 3.1 | 13.9 ± 4.4 | <.001 |
Short | 14.1 ± 2.9 | 14.2 ± 3.1 | .679 | 11.6 ± 2.6 | 9.8 ± 3.4 | <.001 | |||
LCV | Long | 6 | 30.2 ± 4.0 | 30.7 ± 4.1 | .620 | 6 | 32.6 ± 2.7 | 26.8 ± 3.9 | .003 |
Short | 19.0 ± 3.4 | 20.6 ± 3.5 | .110 | 15.9 ± 0.9 | 13.4 ± 2.3 | .084 | |||
Total | Long | 133 | 20.5 ± 4.0 | 20.7 ± 4.1 | .408 | 166 | 19.5 ± 4.3 | 17.2 ± 4.7 | <.001 |
Short | 16.9 ± 3.7 | 17.3 ± 4.0 | .009 | 15.3 ± 4.1 | 13.4 ± 4.4 | <.001 |
Variable | Axis | PFA | RFA | P |
---|---|---|---|---|
RSPV | Long | 0.4 ± 7.4 | −5.8 ± 10.4 | .005 |
Short | 3.2 ± 12.1 | −11.0 ± 12.7 | <.001 | |
RIPV | Long | −0.4 ± 10.7 | −5.4 ± 12.4 | .065 |
Short | 5.4 ± 13.0 | −8.0 ± 13.2 | <.001 | |
LSPV | Long | 1.5 ± 7.0 | −18.7 ± 16.5 | <.001 |
Short | 1.6 ± 11.1 | −16.7 ± 22.8 | <.001 | |
LIPV | Long | 2.1 ± 8.0 | −18.8 ± 20.7 | <.001 |
Short | 2.0 ± 14.5 | −16.4 ± 23.7 | <.001 | |
LCV | Long | 2.2 ± 8.6 | −18.0 ± 8.3 | .002 |
Short | 9.0 ± 11.5 | −15.3 ± 16.8 | .015 | |
Total | Long | 0.9 ± 8.5 | −11.9 ± 16.3 | <.001 |
Short | 3.4 ± 12.7 | −12.9 ± 18.5 | <.001 |



Discussion
PV narrowing and PFA
- Calkins H.
- Kuck K.H.
- Cappato R.
- et al.
- Calkins H.
- Kuck K.H.
- Cappato R.
- et al.
Different patterns of narrowing in mild PV stenosis
Limitations
Reddy VY, Dukkipati SR, 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. Circulation2015;132:907–915.
Conclusion
Appendix. Supplementary data
- Online Supplemental Appendix
References
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Article info
Publication history
Footnotes
Dr VY Reddy is a consultant to and has received stock options in Farapulse, is a consultant to Cardiofocus, and has received grant support from Biosense Webster and Abbott. Dr Reddy also has conflicts with other medical companies unrelated to this manuscript; a full list is provided in the Online Supplemental Appendix. Dr Neuzil has received grant support from Farapulse, Cardiofocus, Biosense Webster, and Abbott. Dr Dukkipati owns stock in Farapulse and Manual Surgical Sciences, serves as a consultant to Cardiofocus, and has received grant support from Biosense Webster. Dr Koruth serves as a consultant to and has received grant support from Farapulse. Mr Eggert, Mr Morrow, and Mr Schneider are the employees of Farapulse. The rest of the authors report no conflicts of interest.
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