Prospective Characterization of Catheter–Tissue Contact Force at Different Anatomic Sites During Antral Pulmonary Vein Isolation

Kumar, Saurabh; Morton, Joseph B.; Lee, Justin; Halloran, K.; Spence, S.; Gorelik, Alexandra; Hepworth, Graham; Kistler, Peter M.; Kalman, Jonathan M.

doi:10.1161/circep.112.972208

Cited by 74 publications

(65 citation statements)

References 17 publications

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“…In recent studies, evaluations of CF during mapping of different predefined right and left atrial sites 8 and during PVI 9,10 were performed. To the best of our knowledge, this was the …”

Section: Discussionmentioning

confidence: 99%

“…Recently, the site-and operator-dependent differences when measuring CF have been reported [8][9][10] ; however, little is known about the detailed analysis of the distribution of CF and about catheter stability during point-by-point LA mapping and PVI using the Smart Touch catheter. To establish a baseline and evaluate the data in the setting of real clinical practice, operators in the present study were blinded to CF information.…”

Section: Clinical Perspective On P 54mentioning

confidence: 99%

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In Vivo Contact Force Analysis and Correlation With Tissue Impedance During Left Atrial Mapping and Catheter Ablation of Atrial Fibrillation

Makimoto

Lin

Rillig

et al. 2014

Circ: Arrhythmia and Electrophysiology

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Background-The aim of this study was to evaluate in vivo contact force (CF) and the correlation of CF with impedance during left atrial 3-dimensional electroanatomical mapping and ablation. Methods and Results-CF during point-by-point left atrial mapping was assessed in 30 patients undergoing atrial fibrillation ablation. Operators were blinded to the real-time CF data. Data were analyzed according to 11 predefined areas in the left atrial and 6 segments around the ipsilateral pulmonary veins. A total of 3475 mapping and 878 ablation points were analyzed. Median CF during mapping was 14.0g (6.5-26.2; q1-q3), ranging from 5.1g at the ridge to 29.8g at the roof. Median CF at the ridge and mitral isthmus were 5.1g and 6.9g, respectively. Extremely high CF ≥100g was noted in 24 points (0.7%). Median CFs during ablation around the right and left pulmonary veins were 22.8g (12.6-37.9; q1-q3) and 12.3g (6.9-30.2; q1-q3), respectively. The lowest median CFs were recorded at the anterior-superior and anteriorinferior segments of the left pulmonary veins (7.2g and 7.9g

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“…In recent studies, evaluations of CF during mapping of different predefined right and left atrial sites 8 and during PVI 9,10 were performed. To the best of our knowledge, this was the …”

Section: Discussionmentioning

confidence: 99%

Section: Clinical Perspective On P 54mentioning

confidence: 99%

In Vivo Contact Force Analysis and Correlation With Tissue Impedance During Left Atrial Mapping and Catheter Ablation of Atrial Fibrillation

Makimoto

Lin

Rillig

et al. 2014

Circ: Arrhythmia and Electrophysiology

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“…Median CF was greater than in the epicardium (15 [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] versus 8 [4][5][6][7][8][9][10][11][12][13] g; P<0.001). The overall median CF using a transseptal approach was not significantly different from a retroaortic approach (16 [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]] versus 14 [8][9][10][11][12][13][14][15]…”

Section: Left Endocardial Cfmentioning

confidence: 99%

Characterization of Contact Force During Endocardial and Epicardial Ventricular Mapping

Jesel

Sacher

Komatsu

et al. 2014

Circ: Arrhythmia and Electrophysiology

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Background— The optimal contact force (CF) for ventricular mapping and ablation remains unvalidated. We assessed CF in different endocardial and epicardial regions during ventricular tachycardia substrate mapping using a CF-sensing catheter (Smartouch; Biosense-Webster) and compared the transseptal versus retroaortic approach. Methods and Results— In total, 8979 mapping points with CF, and force vector orientation (VO) were recorded in 21 patients, comprising 13 epicardial, 12 left ventricular (6 transseptal and 6 retroaortic approach), and 12 right ventricular endocardial maps. VO was defined as adequate when the vector was directed toward the myocardium. During epicardial mapping, 46% of the points showed an adequate VO and a median CF of 8 (4–13) g, however, with significant differences among the 8 regions. When VO was inadequate, median CF was higher at 16 (10–24) g ( P <0.0001). During left ventricular and right ventricular endocardial mapping, 94% of VO were adequate. Median CF of adequate VO was higher in the left ventricular and right ventricular endocardium than in the epicardium (15 [8–25] and 13 [7–22] g versus 8 [4–13] g, respectively; both P <0.001). Global median left ventricular CF with transseptal approach was not statistically different from retroaortic approach, but CF in the apicoinferior and apicoseptal regions was higher with transseptal approach ( P <0.001). Conclusions— Ventricular mapping demonstrates important regional variations in CF, but in general, CF is higher endocardially than epicardially where poor catheter orientation is associated with higher CF. A transseptal approach may lead to improved contact particularly in the apicoseptal and inferior regions.

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“…14 Use of contact force technology can improve lesion efficacy, reduce recovery of PV conduction, 15,16 and improve single-procedure efficacy 17 but is not universally available at present. High-resolution MRI scanning, near-field ultrasound, and lesion thermography hold promise for lesion completeness and gap detection but are not widely available.…”

Section: Article See P 1095mentioning

confidence: 99%

Unipolar Electrogram Morphology to Assess Lesion Formation During Catheter Ablation of Atrial Fibrillation

Kumar

Michaud

2013

Circ: Arrhythmia and Electrophysiology

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Prospective Characterization of Catheter–Tissue Contact Force at Different Anatomic Sites During Antral Pulmonary Vein Isolation

Cited by 74 publications

References 17 publications

In Vivo Contact Force Analysis and Correlation With Tissue Impedance During Left Atrial Mapping and Catheter Ablation of Atrial Fibrillation

In Vivo Contact Force Analysis and Correlation With Tissue Impedance During Left Atrial Mapping and Catheter Ablation of Atrial Fibrillation

Characterization of Contact Force During Endocardial and Epicardial Ventricular Mapping

Unipolar Electrogram Morphology to Assess Lesion Formation During Catheter Ablation of Atrial Fibrillation

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