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Clinical impact of contact force and its regional variability on efficiency and effectiveness of pulmonary vein isolation for atrial fibrillation.pdf

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Clinical impact of contact force and its regional variability on efficiency and effectiveness of pulmonary vein isolation for atrial fibrillation.pdf

Journal of Cardiology 68 (2016) 335–341 Contents lists available at ScienceDirect Journal of Cardiology journal homepage: /locate/jjcc Original article Clinical impact of contact force and its regional variability on ef?ciency and effectiveness of pulmonary vein isolation for atrial ?brillation Yohei Sotomi (MD)a, Koichi Inoue (MD, PhD)a,*, Takayuki Kikkawa b, Koji Tanaka (MD)a, Yuko Toyoshima (MD)a, Takafumi Oka (MD, PhD)a, Nobuaki Tanaka (MD)a, Yoshiyuki Orihara (MD)a, Katsuomi Iwakura (MD, PhD, FJCC)a, Yasushi Sakata (MD, PhD, FJCC)c, Kenshi Fujii (MD, PhD, FJCC)a a Cardiovascular Center, Sakurabashi Watanabe Hospital, Osaka, Japan b Department of Medical Engineering, Sakurabashi Watanabe Hospital, Osaka, Japan c Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan ARTICLE INFO Article history: Received 11 July 2015 Received in revised form 5 October 2015 Accepted 13 October 2015 Available online 19 November 2015 Keywords: Atrial ?brillation Catheter ablation Pulmonary vein isolation Contact force Reccurence ABSTRACT Background: The purpose of this study is to analyze the impact of average contact force (CF) and its regional variability during pulmonary vein isolation (PVI) for atrial ?brillation (AF) on periprocedural parameters and midterm outcome. Methods: This retrospective cohort study enrolled 57 drug-refractory AF patients who underwent initial PVI for AF using an open-irrigated CF catheter (SmartTouch Thermocool, Biosense Webster, Diamond Bar, CA, USA). Thirty patients were assigned to a lower CF (LCF) group (average CF 10 g) and 27 patients to a higher CF (HCF) group (average CF 10 g). The relationship between CF and clinical outcome was analyzed. Results: Patients were followed-up for 317 ? 57 days after PVI. The CF was 8.1 ? 1.3 g in the LCF group and 12.4 ? 1.5 g in the HCF group. Higher average CF was associated with shorter ablation time (28 ? 6 min vs. 36 ? 9 min, p = 0.0002) and lower radiofrequency en