Impact of open-irrigated radiofrequency catheter with contact force measurement on the efficacy and safety of atrial fibrillation ablation: a single-center direct comparison

Abstract

Background In atrial fibrillation (AF) patients, catheter ablation of pulmonary veins (PVI) is the most effective therapeutic option to maintain sinus rhythm. To improve successful PVI, contact force–sensing (CF) catheters became routinely available. Previous studies did not clearly show superior clinical efficacy in comparison with non-CF catheters. Methods We investigated consecutive patients, who underwent index PVI for AF at our hospital between 2012 and 2018. Three hundred and fifty-four patients were ablated without CF. After availability of CF catheters in 2016, 317 patients were ablated using CF. In case of crossover between the groups, follow-up was censored. The primary endpoint was any documented atrial tachycardia (AT) or atrial fibrillation > 30 s after a 3-month blanking period. Secondary endpoints were procedural characteristics and periprocedural complications. Results There was no significant difference between the groups at baseline except hyperlipidemia. After 365 days of follow-up, 67% of patients in the CF group remained free from AF/AT recurrence compared to 59% in non-CF group (P = 0.038). In multivariable Cox regression analysis, non-CF ablation was an independent risk factor for AF recurrence besides age and persistent AF. Total fluoroscopy time (15 ± 7.6 vs. 28 ± 15.9 min) and total procedure time (114 ± 29.6 vs. 136 ± 38.5 min) were significantly lower for CF-guided PVI (P < 0.001). Complication rates did not differ between groups (P = 0.661). Conclusions In our study, the AT/AF recurrence rate and pulmonary vein reconnection rate is lower after CF PVI with a similar complication rate but lower total procedure time and total fluoroscopy time compared to non-CF PVI.

Contact force sensing manual catheter versus remote magnetic navigation ablation of atrial fibrillation: a single-center comparison

“…Our previous data showed better efficacy of manual navigation without contact force sensing compared to RMN [ 16 ]. Based on previous metaanalyses [ 23 – 25 ] and our retrospective data [ 22 ], we hypothesized that manual catheters with CF may yield a better clinical efficacy compared to manual catheters without CF. In the literature, we were able to identify two studies comparing at least 50 patients with MCN-CF to RMN.…”

“…So far, little is known about the efficacy of RMN ablation regarding AF recurrence compared to MCN-CF ablation. We hypothesized, that as proven in our previous retrospective analysis [ 22 ], impact of improved lesion creation with MCN-CF could lead to better clinical outcomes regarding AF recurrences. Our hypothesis was also encouraged by our previous data, directly comparing RMN to MCN without contact force sensing catheters [ 16 ].…”