Updated systematic review and meta-analysis of the impact of contact force sensing on the safety and efficacy of atrial fibrillation ablation: discrepancy between observational studies and randomized control trial data

Virk, Sohaib; Ariyaratnam, Jonathan; Bennett, Richard G.; Kumar, Saurabh

doi:10.1093/europace/euy266

Cited by 36 publications

(36 citation statements)

References 53 publications

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“…CF is identified as a key determinant of lesion size, long term ablation efficacy and safety . A Lot's of observational studies have found overwhelming benefit from CF‐guided AF ablation, however a meta‐analysis of randomized data by Virk et al demonstrated that CF guidance does not improve the safety or efficacy of AF ablation . Even though, CF sensing technology in STc enables real‐time monitoring of CF between the catheter tip and tissues, and confirmed persistent appropriate pressure to effectively facilitate RF energy transfer to the tissue .…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of the ThermoCool SmartTouch SurroundFlow catheter for atrial fibrillation ablation: A meta‐analysis

Chen

Gao

Liu

et al. 2019

Clinical Cardiology

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Background The ThermoCool Smarttouch Surroundflow catheter (STSFc) is an advanced catheter, which integrating contact force sensing and surroundflow technology. However, comparative data between STSFc and contact force sensing catheter (Thermocool SmartTouch catheter [STc]) are limited. Hypothesis We thought that STSFc might bring more clinical benefits. The aim of this meta‐analysis was to compare the safety and efficiency between the STSFc and the STc for treatment of atrial fibrillation (AF). Methods The Medline, PubMed, Embase, and Cochrane Library databases were searched for studies comparing STSFc and STc. Results Four trials involving 727 patients were included in the study. Pool‐analyses demonstrated that, as compared STc ablation, STSFc ablation was more beneficial in terms of procedural times (standard mean difference [SMD]: −0.22; 95% confidence interval [CI], −0.37 to −0.07, P = .005) and irrigation fluid volume (SMD: −1.94; 95% CI, −2.65 to −1.22, P < .0001). There was no significant difference between STSFc and STc (risk ratio [RR]: 1.02; 95% CI: 0.86 to 1.21, P = .79) for free from AF. Evidence of complications were low and similar for both groups (RR: 0.83; 95% CI: 0.19‐3.55, P = .80). Additionally, patients administered STSFc ablation tended to have shorter fluoroscopic times (SMD: −0.20; 95% CI, −0.63‐0.23, P = .21). Conclusions STSFc ablation was associated with reducing procedural times and irrigation fluid volume. Further, STSFc ablation tended to shorten fluoroscopic times. Therefore, STSFc ablation would be a better choice for AF patients especially in patients with heart failure.

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of the ThermoCool SmartTouch SurroundFlow catheter for atrial fibrillation ablation: A meta‐analysis

Chen

Gao

Liu

et al. 2019

Clinical Cardiology

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“… 26 However, more recent meta-analysis of randomized data showed that the availability of real-time CF feedback alone does not necessarily lead to improved clinical outcome or safety, thus introducing controversy about the benefits of this technology. 13 , 27 , 28 The introduction of CF sensing catheters to ventricular tachycardia ablation did not provide additional benefit over non-CF catheters, 29 and most studies reported superiority of RMN-guided over manual (CF/non-CF)–guided ablation. 29 , 30 , 31 As described, RMN uses magnetic force to guide catheters to the targeted myocardial tissue.…”

Section: Discussionmentioning

confidence: 99%

“…However, more recent meta-analysis of randomized data showed that the availability of real-time CF feedback alone does not necessarily lead to improved clinical outcome or safety for CA of AF. 13 One of the currently available RF CA techniques is remote magnetic navigation (RMN)-guided ablation. In RMNguided RF ablation, the ablation catheter has a flexible distal tip and is navigated toward and held to the ablation surface only by magnetic force.…”

Section: Introductionmentioning

confidence: 99%

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Introducing a novel catheter–tissue contact feedback feature in robotic navigated catheter ablation: Utility, feasibility, and safety

et al. 2020

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BACKGROUND The quality of catheter-tissue contact is one of the most important determinants of catheter ablation (CA) success. The absence of catheter-tissue contact feedback has been regarded a major limitation of remote magnetic navigation (RMN)-guided CA. The e-Contact module (ECM) is a novel feature designed for RMN that measures the quality of catheter-tissue contact. OBJECTIVE The purpose of this study was to describe the first clinical experience with this feature and to test its effect on procedural parameters and interference with other ablation equipment during CA procedures as well as its safety. METHODS This was a prospective, single-center, 2-phase study investigating ECM use during complex RMN procedures in 30 patients. Impact of ECM on procedural parameters was evaluated in the feasibility phase (FP), and its interference with other equipment was tested in the interference phase (IP) using pacing maneuvers at 3 randomly selected right atrial sites. Intracardiac electrograms were evaluated for disturbances by 2 independent electrophysiologists. RESULTS For FP, mean procedural time was 162 6 66 minutes, fluoroscopy time 21 6 9 minutes, and ablation time 34 6 21 minutes. For IP, no significant differences in pacing capture or thresholds were found (ECM-vs ECM1: site 1: 2.05 vs 2.21 mA; P 5 .320; site 2: 2.15 vs 2.12 mA; P 5 .873; site 3: 2.51 vs 2.50 mA; P 5 .976). Electrogram disturbances did not significantly differ between ECM-and ECM1. No adverse events were reported. CONCLUSION The ECM is a novel catheter-tissue contact technology designed for RMN-guided CA. Our study suggests that this feature is feasible and does not interfere with other electrophysiology equipment while maintaining an excellent safety profile.

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“… 2 Moreover, even though observational data have demonstrated improvement in safety with contact force sensing technology, in a recent meta-analysis, analysis of randomized data has failed to demonstrate any favorable impact. 3 One of the latest trends in AF ablation is high-power short-duration (HPSD) ablation, which aims to improve lesion transmurality and durability, therefore improve outcomes. 4 , 5 HPSD energy settings have varied between studies: starting from 45 up to 90Watts.…”

Section: Introductionmentioning

confidence: 99%

Triple gastrointestinal prophylactic therapy following high-power short-duration posterior left atrial wall ablation

Candemir

Baskovski

Mammadov

et al. 2020

Indian Heart Journal

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The purpose of this study is to investigate incidence of gastrointestinal symptoms and complications in patients who underwent high-power short-duration (HPSD), posterior left atrial wall isolation during atrial fibrillation ablation and thereafter have received gastrointestinal prophylactic regimen consisting of sucralfate, proton-pump inhibitor and colchicine. Patients were followed and assessed at baseline, up until 6th month following the procedures.Among 115 patients who were included, 5 patients (4.3%) reported gastrointestinal symptoms at follow-up. No complications were diagnosed during the follow-up. In conclusion, the HPSD along with prophylactic regimen has been associated with low incidence of gastrointestinal adverse events.

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Updated systematic review and meta-analysis of the impact of contact force sensing on the safety and efficacy of atrial fibrillation ablation: discrepancy between observational studies and randomized control trial data

Cited by 36 publications

References 53 publications

Safety and efficacy of the ThermoCool SmartTouch SurroundFlow catheter for atrial fibrillation ablation: A meta‐analysis

Safety and efficacy of the ThermoCool SmartTouch SurroundFlow catheter for atrial fibrillation ablation: A meta‐analysis

Introducing a novel catheter–tissue contact feedback feature in robotic navigated catheter ablation: Utility, feasibility, and safety

Triple gastrointestinal prophylactic therapy following high-power short-duration posterior left atrial wall ablation

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