title: Clinical impact of an open-irrigated radiofrequency catheter with direct force measurement on atrial fibrillation ablation.
abstract: BACKGROUND
  Electrode-tissue contact is crucial for adequate lesion formation in radiofrequency catheter ablation (RFCA).
  
  
  OBJECTIVE
  We assessed the impact of direct catheter force measurement on acute procedural parameters during RFCA of atrial fibrillation (AF).
  
  
  METHODS
  Fifty consecutive patients (28 male) with paroxysmal AF who underwent their first procedure of circumferential pulmonary vein (PV) isolation (PVI) were assigned to either RFCA using (1) a standard 3.5-mm open-irrigated-tip catheter or (2) a catheter with contact force measurement capabilities. Using the endpoint of PVI with entry and exit block, acute procedural parameters were assessed.
  
  
  RESULTS
  Procedural data showed a remarkable decline in ablation time (radiofrequency time needed for PVI) from 50.5 ± 15.9 to 39.0 ± 11.0 minutes (P = 0.007) with a reduction in overall procedure duration from 185 ± 46 to 154 ± 39 minutes (P = 0.022). In parallel, the total energy delivered could be significantly reduced from 70,926 ± 19,470 to 58,511 ± 14,655 Ws (P = 0.019). The number of acute PV reconnections declined from 36% to 12% (P = 0.095).
  
  
  CONCLUSIONS
  The use of contact force sensing technology is able to significantly reduce ablation and procedure times in PVI. In addition, energy delivery is substantially reduced by avoiding radiofrequency ablation in positions with insufficient surface contact. Procedural efficacy and safety of this new feature have to be evaluated in larger cohorts.
authors.affiliation: Department of Cardiology, Elisabethinen University Teaching Hospital of the Universities Innsbruck and Graz, Linz, Austria. martin.martinek@elisabethinen.or.at
authors.forename: Martin
authors.initials: M
authors.lastname: Martinek
authors.forename: Christine
authors.initials: C
authors.lastname: Lemes
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Sigmund
authors.forename: Michael
authors.initials: M
authors.lastname: Derndorfer
authors.forename: Josef
authors.initials: J
authors.lastname: Aichinger
authors.forename: Siegmund
authors.initials: S
authors.lastname: Winter
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Nesser
authors.forename: Helmut
authors.initials: H
authors.lastname: Pürerfellner
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation*; D004566:Electrodes; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013314:Stress, Mechanical; D007507:Therapeutic Irrigation / Q000295:instrumentation*; D014160:Transducers, Pressure; D016896:Treatment Outcome