Scientific Publications Database
Article Title: Three-year outcomes and reconnection patterns after initial contact force guided pulmonary vein isolation for paroxysmal atrial fibrillationAuthors: Nair, Girish M.; Yeo, Colin; MacDonald, Zachary; Ainslie, Mark P.; Alqarawi, Wael A.; Nery, Pablo B.; Redpath, Calum J.; Sadek, Mouhannad; Spence, Stewart; Green, Martin S.; Birnie, David H.
Journal: JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY Volume 28 Issue 9
Date of Publication:2017
Abstract:
Background and objective: Contact force (CF) sensing is a novel technology used for catheter ablation of atrial fibrillation (AF). We compared the single procedure success of CF-guided pulmonary vein isolation (PVI) with that of non-CF guided PVI during a 3-year (1,095 days) follow up period and analyzed the pattern of pulmonary vein (PV) reconnection.Methods: A cohort of 167 subjects (68 CF vs. 99 non-CF) with paroxysmal AF were included in the study. Atrial arrhythmia (AA) recurrence was defined as documented AF, atrial flutter, or atrial tachycardia lasting > 30 seconds and occurring after 90 days.Results: Subjects in the CF group showed a statistically nonsignificant improvement in AA free survival compared to those in the non-CF group (66.2% vs. 51.5%; P value: 0.06). A greater propensity for reconnection was noted around the right-sided PVs compared to left-sided PVs related in both catheter ablation groups. For example, in the CF group 36% of right-sided segments reconnected compared to 16% of left-sided segments (P value < 0.01).Conclusions: A greater propensity for reconnection was noted around the right sided PV segments in both the CF and non-CF groups. The explanation for this finding was related to greater catheter instability around the right sided veins. Further research is needed to explore the utility of a real-time composite indicator that includes RF energy, CF and catheter stability in predicting transmural lesion formation during catheter ablation.