Effect of respiration on catheter-tissue contact force during ablation of atrial arrhythmias

Electrogram-Gated Radiofrequency Ablations With Duty Cycle Power Delivery Negate Effects of Ablation Catheter Motion

“…5 This can translate to poor catheter contact force, nontransmural lesions, longer ablation times, and higher reconnection rates because of gaps between ablation lesions. 8 This study simulated the catheter lateral sliding movements in a previously validated thermochromic liquid crystal myocardial phantom model to demonstrate that conventional (ie, nonelectrogram gated) radiofrequency ablations produced significantly shallower lesions as the degree of catheter surface sliding distance progressively lengthened. In addition, it was shown that lesion length (in the Figure 2.…”

“…3,4,8,[11][12][13] Although a higher contact force should be associated with improved stability, this needs to be balanced against the potential for serious complications, such as cardiac perforation and tamponade, especially at thin target tissues that are not structurally well supported (such as the posterior left atrial wall). In addition, anatomic locations, such as the left anterior superior ridge and the right septal superior position during pulmonary vein isolation, have been shown to be associated with lower achievable contact force during ablation performed by experienced proceduralists.…”

“…Indeed physicians consider performing high-frequency JET ventilated or even apnoeic ablations to provide a steadier ablation platform. 8,[24][25][26][27] The present study chose to exclude respiratory motion in the in vitro ablations because the apnoeic option exists in vivo.…”

Impact of respiration gating on image integration guided atrial fibrillation ablation

“…Catheter-tissue contact force is also critically influenced by respiration [14,15]. However, it seems to be directly related to the respiratory movement itself and it is hard to suggest that the respiratory gating had positive effects on contact force.…”

Catheter Ablation for Atrial Fibrillation in the Real World

“…The use of general anesthesia vs. conscious sedation varies by geographic location and ultimately depends on local preferences and availability. There are some preliminary data suggesting that general anesthesia may provide greater catheter stability and contact force, 15 and increase the single procedure success rate. 16 The increasing use of novel OAC, as realized by this report, is inevitable as physicians move away from the inconvenience of frequent monitoring and dose adjustments, dietary restrictions, and the delayed and prolonged effects of VKA in preference to the novel OAC with more predictable pharmacokinetics and pharmacodynamics.…”