Operator-blinded contact force monitoring during pulmonary vein isolation using conventional and steerable sheaths

Takehiro Kimura, Seiji Takatsuki, Ako Oishi, Masachika Negishi, Shin Kashimura, Yoshinori Katsumata, Takahiko Nishiyama, Nobuhiro Nishiyama, Yoko Tanimoto, Yoshiyasu Aizawa, Keiichi Fukuda

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background We performed contact force (CF) monitoring during pulmonary vein (PV) isolation to evaluate CF according to sheath type, catheter position, and inadequate ablation.

Methods Thirty consecutive patients (paroxysmal atrial fibrillation, 23; CHADS2 score, 0.5 ± 0.7; age, 56 ± 10 years) who underwent PV isolation using a CF-sensing catheter were included. Data for operator-blinded CF, impedance, and duration of the "first touch" (first round of ablation in each PV) was collected. We compared the CF, maximum CF, force-time integral, average impedance, and impedance drop (Δ impedance) between different sheaths (Swartz™ vs. Agilis™) in 12 different catheter positions, and in inadequate first touches requiring additional ablation.

Results A total of 1283 ablation points (Swartz™, 620 points; Agilis™, 663 points) were evaluated. The average CF was significantly higher in the Agilis™ group (17.8 ± 13.0 g) than the Swartz™ group (15.0 ± 12.4 g; P < 0.001), especially in the anterior, inferior-anterior, and inferior-posterior sections of the right PV, and the top of the roof, and calina of the left PV. The Δ impedance showed a mildly significant negative relationship with the average CF (r = - 0.206; P < 0.001) and with the force-time integral (r = - 0.279; P < 0.001). Compared to first touches, the average CF and Δ impedance were significantly smaller in inadequate first touches in the Swartz™ group, but not in the Agilis™ group.

Conclusions CF for PV isolation was significantly different depending on the position of the catheter and the type of sheath.

Original languageEnglish
Pages (from-to)970-976
Number of pages7
JournalInternational Journal of Cardiology
Volume177
Issue number3
DOIs
Publication statusPublished - 2014 Dec 20

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Pulmonary Veins
Electric Impedance
Touch
Catheters
Atrial Fibrillation

Keywords

  • Atrial fibrillation
  • Contact force
  • Pulmonary vein isolation
  • Radiofrequency catheter ablation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Operator-blinded contact force monitoring during pulmonary vein isolation using conventional and steerable sheaths. / Kimura, Takehiro; Takatsuki, Seiji; Oishi, Ako; Negishi, Masachika; Kashimura, Shin; Katsumata, Yoshinori; Nishiyama, Takahiko; Nishiyama, Nobuhiro; Tanimoto, Yoko; Aizawa, Yoshiyasu; Fukuda, Keiichi.

In: International Journal of Cardiology, Vol. 177, No. 3, 20.12.2014, p. 970-976.

Research output: Contribution to journalArticle

Kimura, T, Takatsuki, S, Oishi, A, Negishi, M, Kashimura, S, Katsumata, Y, Nishiyama, T, Nishiyama, N, Tanimoto, Y, Aizawa, Y & Fukuda, K 2014, 'Operator-blinded contact force monitoring during pulmonary vein isolation using conventional and steerable sheaths', International Journal of Cardiology, vol. 177, no. 3, pp. 970-976. https://doi.org/10.1016/j.ijcard.2014.09.189
Kimura, Takehiro ; Takatsuki, Seiji ; Oishi, Ako ; Negishi, Masachika ; Kashimura, Shin ; Katsumata, Yoshinori ; Nishiyama, Takahiko ; Nishiyama, Nobuhiro ; Tanimoto, Yoko ; Aizawa, Yoshiyasu ; Fukuda, Keiichi. / Operator-blinded contact force monitoring during pulmonary vein isolation using conventional and steerable sheaths. In: International Journal of Cardiology. 2014 ; Vol. 177, No. 3. pp. 970-976.
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abstract = "Background We performed contact force (CF) monitoring during pulmonary vein (PV) isolation to evaluate CF according to sheath type, catheter position, and inadequate ablation.Methods Thirty consecutive patients (paroxysmal atrial fibrillation, 23; CHADS2 score, 0.5 ± 0.7; age, 56 ± 10 years) who underwent PV isolation using a CF-sensing catheter were included. Data for operator-blinded CF, impedance, and duration of the {"}first touch{"} (first round of ablation in each PV) was collected. We compared the CF, maximum CF, force-time integral, average impedance, and impedance drop (Δ impedance) between different sheaths (Swartz™ vs. Agilis™) in 12 different catheter positions, and in inadequate first touches requiring additional ablation.Results A total of 1283 ablation points (Swartz™, 620 points; Agilis™, 663 points) were evaluated. The average CF was significantly higher in the Agilis™ group (17.8 ± 13.0 g) than the Swartz™ group (15.0 ± 12.4 g; P < 0.001), especially in the anterior, inferior-anterior, and inferior-posterior sections of the right PV, and the top of the roof, and calina of the left PV. The Δ impedance showed a mildly significant negative relationship with the average CF (r = - 0.206; P < 0.001) and with the force-time integral (r = - 0.279; P < 0.001). Compared to first touches, the average CF and Δ impedance were significantly smaller in inadequate first touches in the Swartz™ group, but not in the Agilis™ group.Conclusions CF for PV isolation was significantly different depending on the position of the catheter and the type of sheath.",
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AU - Kimura, Takehiro

AU - Takatsuki, Seiji

AU - Oishi, Ako

AU - Negishi, Masachika

AU - Kashimura, Shin

AU - Katsumata, Yoshinori

AU - Nishiyama, Takahiko

AU - Nishiyama, Nobuhiro

AU - Tanimoto, Yoko

AU - Aizawa, Yoshiyasu

AU - Fukuda, Keiichi

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Y1 - 2014/12/20

N2 - Background We performed contact force (CF) monitoring during pulmonary vein (PV) isolation to evaluate CF according to sheath type, catheter position, and inadequate ablation.Methods Thirty consecutive patients (paroxysmal atrial fibrillation, 23; CHADS2 score, 0.5 ± 0.7; age, 56 ± 10 years) who underwent PV isolation using a CF-sensing catheter were included. Data for operator-blinded CF, impedance, and duration of the "first touch" (first round of ablation in each PV) was collected. We compared the CF, maximum CF, force-time integral, average impedance, and impedance drop (Δ impedance) between different sheaths (Swartz™ vs. Agilis™) in 12 different catheter positions, and in inadequate first touches requiring additional ablation.Results A total of 1283 ablation points (Swartz™, 620 points; Agilis™, 663 points) were evaluated. The average CF was significantly higher in the Agilis™ group (17.8 ± 13.0 g) than the Swartz™ group (15.0 ± 12.4 g; P < 0.001), especially in the anterior, inferior-anterior, and inferior-posterior sections of the right PV, and the top of the roof, and calina of the left PV. The Δ impedance showed a mildly significant negative relationship with the average CF (r = - 0.206; P < 0.001) and with the force-time integral (r = - 0.279; P < 0.001). Compared to first touches, the average CF and Δ impedance were significantly smaller in inadequate first touches in the Swartz™ group, but not in the Agilis™ group.Conclusions CF for PV isolation was significantly different depending on the position of the catheter and the type of sheath.

AB - Background We performed contact force (CF) monitoring during pulmonary vein (PV) isolation to evaluate CF according to sheath type, catheter position, and inadequate ablation.Methods Thirty consecutive patients (paroxysmal atrial fibrillation, 23; CHADS2 score, 0.5 ± 0.7; age, 56 ± 10 years) who underwent PV isolation using a CF-sensing catheter were included. Data for operator-blinded CF, impedance, and duration of the "first touch" (first round of ablation in each PV) was collected. We compared the CF, maximum CF, force-time integral, average impedance, and impedance drop (Δ impedance) between different sheaths (Swartz™ vs. Agilis™) in 12 different catheter positions, and in inadequate first touches requiring additional ablation.Results A total of 1283 ablation points (Swartz™, 620 points; Agilis™, 663 points) were evaluated. The average CF was significantly higher in the Agilis™ group (17.8 ± 13.0 g) than the Swartz™ group (15.0 ± 12.4 g; P < 0.001), especially in the anterior, inferior-anterior, and inferior-posterior sections of the right PV, and the top of the roof, and calina of the left PV. The Δ impedance showed a mildly significant negative relationship with the average CF (r = - 0.206; P < 0.001) and with the force-time integral (r = - 0.279; P < 0.001). Compared to first touches, the average CF and Δ impedance were significantly smaller in inadequate first touches in the Swartz™ group, but not in the Agilis™ group.Conclusions CF for PV isolation was significantly different depending on the position of the catheter and the type of sheath.

KW - Atrial fibrillation

KW - Contact force

KW - Pulmonary vein isolation

KW - Radiofrequency catheter ablation

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