ThermoCool® SmartTouch® Catheter – The Evidence So Far for Contact Force Technology and the Role of VisiTag™ Module

Lin, Tina; Ouyang, Feifan; Kück, Karl‐Heinz; Tilz, Roland Richard

doi:10.15420/aer.2011.3.1.44

Cited by 23 publications

(6 citation statements)

References 35 publications

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“…This provides a better and more stable catheter contact in these areas 7 . The visualization of the shaft's catheter is a characteristic of the Smart‐Touch catheter 6 . It permits to see all the catheter (from tip to shaft) during looping movements in the right atrium to perform the inversion catheter technique, as described by Sporton using fluoroscopy in 2004 7 .…”

Section: Discussionmentioning

confidence: 99%

“…The poor catheter contact, sometimes because of inadequate power delivery, discontinuous ablation line, and the presence of pouches, recesses, ridges, and trabeculations of CTI, could be the potential contributor to the failure of CTI ablation 5 . The use of irrigated catheter, the drop impedance value, the contact force, Visitag, and ablation index have permitted a more precise assessment of the lesion development during RF 6 . The catheter inversion and the use of the force sensor provided an improved approach to CTI ablation, to achieve a bidirectional block of CTI in difficult anatomies 7 .…”

Section: Introductionmentioning

confidence: 99%

“… 5 The use of irrigated catheter, the drop impedance value, the contact force, Visitag, and ablation index have permitted a more precise assessment of the lesion development during RF. 6 The catheter inversion and the use of the force sensor provided an improved approach to CTI ablation, to achieve a bidirectional block of CTI in difficult anatomies. 7 The catheter inversion was described using fluoroscopy to avoid accidental damage of atrial and atrioventricular structures.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Catheter inversion during cavotricuspid isthmus catheter ablation: The new shaft visualization catheter reduces fluoroscopy use

Santoro

Baiocchi

Sisti

et al. 2021

Journal of Arrhythmia

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Aims Catheter ablation (CA) is the choice therapy of cavotricuspid isthmus (CTI) atrial flutter. The aim of this study was to describe our approach to improve the CTI ablation using a zero‐fluoroscopy (ZF). The procedural difficulties could be related to anatomical characteristics of the CTI. Methods One hundred eighty‐eight patients that performed CA of CTI were retrospectively and consecutively evaluated between 2017 and 2019. The studied population was divided into two groups. Eighty‐eight patients who were undergone CA using ablation catheter without shaft visualization catheter (NSV) were Group 1. One hundred patients were undergone CA using ablation catheter with a shaft visualization (SV); they were Group 2. The catheter was looped at the Eustachian ridge after 200 seconds of radiofrequencies (RF) without elimination of local electrogram. Results A conduction line block of CTI was obtained in all patients of Group 2 using a ZF approach. In 16 patients of Group 1, the catheter inversion was obtained using fluoroscopy to avoid damages during its loop. In Group 2, a complete CTI block was obtained with a catheter inversion approach in ten patients without fluoroscopy, visualizing the shaft and the tip of the ablation catheter on the electroanatomic (EAM) map. In the overall population studied the use of SV had a linear correlation with the ZF approach (r = .629; P < .001). The duration of RF was lower in Group 2 than in Group 1 (Group 1: 27.8 ± 6.3 vs Group 2: 15.6 ± 7.2 minutes; P < .01). The procedure time between two groups was lower in Group 2 than in Group 1 (Group 1: 58.4 ± 22.4 vs Group 2: 42.2 ± 15.7 minutes; P < .01). No differences between two groups were documented regarding success and complications. Conclusions The visualization of the shaft's catheter on the EAM permitted the catheter inversion safely in order to overcome some complex CTI anatomy and obtain bidirectional block. The SV reduced procedure time, RF applications and fluoroscopy exposition during CTI ablation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Catheter inversion during cavotricuspid isthmus catheter ablation: The new shaft visualization catheter reduces fluoroscopy use

Santoro

Baiocchi

Sisti

et al. 2021

Journal of Arrhythmia

View full text Add to dashboard Cite

show abstract

“…However, neither the size nor the color of these generic markers correlates with the size or quality of the lesion, 16 hence providing no information on the lesion quality. In addition to the glyphs that mark the "ablated" locations, extensions of the traditional EAM systems, such as the VisiTag technology, 17 show the user a "gauge" whose color changes according to the ablation index estimated at a specific location based on power, contact force, and ablation time. 18 This technology presents an improvement over the traditional EAM systems, as it provides feedback based on contact force and ablation duration.…”

Section: Introductionmentioning

confidence: 99%

Lesion modeling, characterization, and visualization for image-guided cardiac ablation therapy monitoring

et al. 2018

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In spite of significant efforts to improve image-guided ablation therapy, a large number of patients undergoing ablation therapy to treat cardiac arrhythmic conditions require repeat procedures. The delivery of insufficient thermal dose is a significant contributor to incomplete tissue ablation, in turn leading to the arrhythmia recurrence. Ongoing research efforts aim to better characterize and visualize RF delivery to monitor the induced tissue damage during therapy. Here, we propose a method that entails modeling and visualization of the lesions in real-time. The described image-based ablation model relies on classical heat transfer principles to estimate tissue temperature in response to the ablation parameters, tissue properties, and duration. The ablation lesion quality, geometry, and overall progression are quantified on a voxel-by-voxel basis according to each voxel's cumulative temperature and time exposure. The model was evaluated both numerically under different parameter conditions, as well as experimentally, using bovine tissue samples undergoing clinically relevant ablation protocols. The studies demonstrated less than 5°C difference between the model-predicted and experimentally measured end-ablation temperatures. The model predicted lesion patterns were within 0.5 to 1 mm from the observed lesion patterns, suggesting sufficiently accurate modeling of the ablation lesions. Lastly, our proposed method enables therapy delivery feedback with no significant workflow latency. This study suggests that the proposed technique provides reasonably accurate and sufficiently fast visualizations of the delivered ablation lesions.

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“…The parameters include the catheter position stability, CF over time, IMP drop, and target temperature. Furthermore, the color of the tag changes basedon predefined parameters like the total time, CF, and FTI level 16.…”

mentioning

confidence: 99%

Comparison of the efficacy between impedance‐guided and contact force‐guided atrial fibrillation ablation using an automated annotation system

Park

Kim

Yoon

et al. 2018

Journal of Arrhythmia

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BackgroundThis study compared the efficacy of catheter ablation of atrial fibrillation (AF) between impedance (IMP)‐guided and contact force (CF)‐guided annotation using the automated annotation system (VisiTag™).MethodsFifty patients undergoing pulmonary vein isolation (PVI) for AF were randomized to the IMP‐guided or CF‐guided groups. The annotation criteria for VisiTag™ were a 10 second minimum ablation time and 2 mm maximum catheter movement range. A minimum CF of 10 g was added to the criteria in the CF‐guided group. In the IMP‐guided group, a minimum IMP drop of over 5 Ω was added to the criteria.ResultsThe rates of successful PVI after an initial ablation line were higher in the CF‐guided group (80% vs 48%, P = .018). Although average CF was similar between two groups, the average force‐time integral (FTI) was significantly higher in the CF‐guided group (298.3 ± 65. 2 g·s vs 255.1 ± 38.3 g·s, P = .007). The atrial arrhythmia‐free survival at 1 year demonstrated no difference between the two groups (84.0% in the IMP‐guided group vs 80.0% in the CF‐guided group, P = .737). If the use of any antiarrhythmic drug beyond the blanking period was considered as a failure, the clinical success rate at 1 year was 52.0% for the CF‐guided group vs 56.0% for the IMP‐guided group (P = .813).ConclusionsAtrial fibrillation ablation using an automated annotation system guided by CF improved the success rate of PVI after the initial circumferential ablation. An IMP‐guided annotation combined with catheter stability criteria showed similar clinical outcomes as compared to the CF‐guided annotation.

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ThermoCool® SmartTouch® Catheter – The Evidence So Far for Contact Force Technology and the Role of VisiTag™ Module

Cited by 23 publications

References 35 publications

Catheter inversion during cavotricuspid isthmus catheter ablation: The new shaft visualization catheter reduces fluoroscopy use

Catheter inversion during cavotricuspid isthmus catheter ablation: The new shaft visualization catheter reduces fluoroscopy use

Lesion modeling, characterization, and visualization for image-guided cardiac ablation therapy monitoring

Comparison of the efficacy between impedance‐guided and contact force‐guided atrial fibrillation ablation using an automated annotation system

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