scholarly journals Catheter-related complications and mortality of atrial fibrillation ablation following introduction of contact force-sensing technology

2020 ◽  
Vol 2 (1) ◽  
pp. e000058
Author(s):  
Joseph G Akar ◽  
James P Hummel ◽  
Xiaoxi Yao ◽  
Lindsey Sangaralingham ◽  
Sanket Dhruva ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Acute Care ◽  
Contact Force ◽  
Emergency Department Visits ◽  
Atrial Fibrillation Ablation ◽  
Esophageal Injury ◽  
Force Sensing ◽  
Complication Rates ◽  
Af Ablation ◽  
Complications And Mortality

ObjectivesContact force-sensing catheters allow real-time catheter-tissue contact force monitoring during atrial fibrillation. These catheters were rapidly adopted into clinical practice following market introduction in 2014, but concerns have been raised regarding collateral damage such as esophageal injury. We sought to examine whether the introduction of force-sensing catheters was associated with a change in short-term and intermediate-term acute care use, complications and mortality following atrial fibrillation ablation.DesignRetrospective cohort analysis. We used inverse probability treatment weight matching to account for the differences in baseline characteristics between groups.SettingWe examined patients included in the OptumLabs Data Warehouse who underwent ablation for atrial fibrillation before (2011–2013) and after (2015–2017) the market introduction of contact force-sensing catheters.Main outcome measuresWe examined 30-day and 90-day rates of all-cause acute care use, including hospitalizations and emergency department visits, as well as death and hospitalization for catheter-related complications, including atrioesophageal fistula, pericarditis, cardiac tamponade/perforation and stroke/transient ischemic attack.ResultsOur sample included 3470 and 5772 patients who underwent atrial fibrillation (AF) ablation before and after market introduction of contact force-sensing catheters, respectively. Complication rates were low and did not differ between the two periods (p>0.10 for each outcome). The 30-day and 90-day mortality was 0.1% and 0.3%, respectively after market introduction and unchanged from prior to 2014. The 90-day rates of all-cause acute care use decreased, from 27.0% in 2011–2013 to 23.9% in 2015–2017 (p<0.001).ConclusionsAF ablation-related catheter complications and mortality are low and there has been no significant change following the introduction of force-sensing catheters.

scholarly journals P371Impact of contact force sensing ablation catheter on atrial fibrillation ablation procedure

EP Europace ◽  
2017 ◽  
Vol 19 (suppl_3) ◽  
pp. iii70-iii70
Author(s):  
C. Arantes ◽  
N. Cortez-Dias ◽  
J. Agostinho ◽  
IS. Goncalves ◽  
G. Lima Da Silva ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Contact Force ◽  
Atrial Fibrillation Ablation ◽  
Force Sensing ◽  
Ablation Catheter ◽  
Ablation Procedure

scholarly journals Atrial fibrillation ablation with a spring sensor-irrigated contact force-sensing catheter compared with other ablation catheters: systematic literature review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e023775 ◽  
Author(s):  
Laurent Macle ◽  
Diana Frame ◽  
Larry M Gache ◽  
George Monir ◽  
Scott J Pollak ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Literature Review ◽  
Contact Force ◽  
Systematic Literature Review ◽  
Meta Analysis ◽  
Safety Data ◽  
Percutaneous Ablation ◽  
Complication Rates ◽  
Success Rates ◽  
Af Ablation

ObjectivesThe objective of our review was to systematically assess available evidence on the effectiveness, safety and efficiency of a spring sensor-irrigated contact force (CF) catheter (THERMOCOOL SMARTTOUCH Catheter (ST)) for percutaneous ablation of paroxysmal or persistent atrial fibrillation (AF), compared with other ablation catheters, or with the ST with the operator blinded to CF data.DesignSystematic literature review and meta-analysis.BackgroundEmerging evidence suggests improved clinical outcomes of AF ablation using CF-sensing catheters; however, reviews to date have included data from multiple, distinct CF technologies.MethodsWe conducted a systematic review and meta-analysis of published studies comparing the use of ST versus other ablation catheters for the treatment of AF. A comprehensive search of electronic and manual sources was conducted. The primary endpoint was freedom from recurrent atrial tachyarrhythmia (AT) at 12 months. Procedural and safety data were also analysed.ResultsThirty-four studies enrolling 5004 patients were eligible. The use of ST was associated with increased odds of freedom from AT at 12 months (71.0%vs60.8%; OR 1.454, 95% CI 1.12 to 1.88, p=0.004) over the comparator group, and the effect size was most evident in paroxysmal AF patients (75.6%vs64.7%; OR 1.560, 95% CI 1.09 to 2.24, p=0.015). Procedure and fluoroscopy times were shorter with ST (p=0.05 and p<0.01, respectively, vs comparator groups). The reduction in procedure time is estimated at 15.5 min (9.0%), and fluoroscopy time 4.8 min (18.7%). Complication rates, including cardiac tamponade, did not differ between groups.ConclusionsCompared with the use of other catheters, AF ablation using the CF-sensing ST catheter for AF is associated with improved success rates, shorter procedure and fluoroscopy times and similar safety profile.

P1383Procedural differences during de novo paroxysmal atrial fibrillation ablation with a contact force-sensing ablation catheter between Europe and U.S

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
H Ramanna ◽  
J L Lloret ◽  
F Zahwe ◽  
C Porterfield ◽  
S Trines ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Contact Force ◽  
Paroxysmal Atrial Fibrillation ◽  
De Novo ◽  
Magnetic Sensor ◽  
Atrial Fibrillation Ablation ◽  
Force Sensing ◽  
Ablation Catheter ◽  
Clinical Practices ◽  
Procedural Time

Abstract Background Although pulmonary vein isolation (PVI) is considered the standard approach of atrial fibrillation ablation worldwide, procedural practice during the ablation varies by geographical region. Using the same magnetic sensor enabled contact force-sensing ablation catheter for the treatment of de novo paroxysmal atrial fibrillation, a comparison of procedural detail between Europe and U.S operators can provide insights into geographic specific clinical practices.  Purpose To characterize and compare procedural differences during paroxysmal atrial fibrillation ablation performed with a magnetic sensor enabled contact force-sensing catheter across European and U.S. centers.  Methods Procedural data were prospectively collected in clinical cases performed with a new magnetic sensor enabled, contact force ablation catheter within the first 6 months of use at participating centers in Europe and the U.S. Procedure time, PVI time, PVI confirmation method, fluoroscopy usage and lesion delivery parameters were analyzed based on geographies.  Results A total of 131 cases across 35 centers in 11 European countries, and 95 cases across 26 U.S. centers were analyzed. Target geometry was created with the ablation catheter in 94 out of 131 (71.8%) European cases, while only 5 out of 95 U.S. cases (5.3%) reported the use of the ablation catheter for model creation. Although a steerable sheath (64.1% and 67.3%) was commonly used with the ablation catheter in both geographies, difference in the utilization of bidirectional contact force catheter (52.7% and 90.5%) and the automated lesion marking module (76.3% and 81.1%) were observed in European and U.S. cases, respectively. The use of adenosine or isoproterenol to confirm PVI was reported in 25% and 64% of the European and U.S. cases. Average waiting periods were 18.2 minutes and 26.5 minutes from reported European and U.S. cases. Total procedural time, mapping time, and fluoroscopy time were similar between European and U.S. cases. (Table). First pass PVI were 66.4% and 72.6% for European and U.S. cases, respectively. Conclusion Total procedural time and RF time were similar between European and U.S. cases during de novo paroxysmal atrial fibrillation ablation using the same ablation catheter. Differences in workflow including the use of a mapping catheter for geometry creation and waiting period were observed between the two geographies. Summary of procedural details De novo PAF N Procedural time(min) Mapping time (min) PVI time (min) Total RF time (min) Fluoro time( min) Europe 131 144.0 ± 56.9 16.6 ± 17.1 69.8 ± 35.0 33.2 ± 15.6 11.6 ± 10.1 U.S. 95 137.6 ± 64.8 18.1 ± 23.5 58.8 ± 31.5 32.3 ± 22.2 12.0 ± 15.8

Persistent Atrial Fibrillation Ablation With or Without Contact Force Sensing

2017 ◽  
Vol 28 (5) ◽  
pp. 483-488 ◽  
Author(s):  
AYMAN A. HUSSEIN ◽  
AMR F. BARAKAT ◽  
WALID I. SALIBA ◽  
KHALDOUN G. TARAKJI ◽  
MOHAMED BASSIOUNY ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Contact Force ◽  
Persistent Atrial Fibrillation ◽  
Atrial Fibrillation Ablation ◽  
Force Sensing

scholarly journals INCREASED RATE OF POSTOPERATIVE PERICARDITIS WITH CONTACT FORCE SENSING CATHETERS IN ATRIAL FIBRILLATION ABLATION

2016 ◽  
Vol 67 (13) ◽  
pp. 758 ◽  
Author(s):  
Cilomar Martins de Oliveira Filho ◽  
Roderick Tung ◽  
Jason Bradfield ◽  
Marmar Vaseghi ◽  
Olujimi Ajijola ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Contact Force ◽  
Atrial Fibrillation Ablation ◽  
Force Sensing

Contact Force-Sensing Catheters in Atrial Fibrillation Ablation: A Meta-Analysis of Randomised Controlled Studies

2018 ◽  
Vol 27 ◽  
pp. S157-S158
Author(s):  
T. Rattanakosit ◽  
T. Agbaedeng ◽  
D. Lau ◽  
D. Linz ◽  
P. Sanders ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Contact Force ◽  
Meta Analysis ◽  
Atrial Fibrillation Ablation ◽  
Force Sensing ◽  
Randomised Controlled
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