title: Catheter-tissue contact force for pulmonary veins isolation: a pilot multicentre study on effect on procedure and fluoroscopy time.
abstract: OBJECTIVE
  Catheter-tissue contact is critical for effective lesion creation in radiofrequency catheter ablation (RFCA). In a multicentre prospective study, we assessed the effect of direct contact force (CF) measurement on acute procedural parameters during RFCA of atrial fibrillation (AF).
  
  
  RESULTS
  A new open-irrigated tip catheter with CF sensing (SmartTouch™, Biosense Webster Inc.) was used. All the patients underwent the first ablation procedure for paroxysmal AF with antral pulmonary vein (PV) isolation, aiming at entry and exit conduction block in all PVs. Ninety-five patients were enroled in nine centres and successfully underwent ablation. Overall procedure time, fluoroscopy time, and ablation time were 138.0 ± 67.0, 14.3 ± 11.2, and 33.8 ± 19.4 min, respectively. The mean CF value during ablation was 12.2 ± 3.9 g. Force time integral (FTI) analysis showed that patients achieving a value below the median of 543.0gs required longer procedural (158.0 ± 74.0 vs. 117.0 ± 52.0 min, P = 0.004) and fluoroscopy (17.5 ± 13.0 vs. 11.0 ± 7.7 min, P = 0.007) times as compared with those in whom FTI was above this value. Patients in whom the mean CF during ablation was >20 g required shorter procedural time (92.0 ± 23.0 vs. 160.0 ± 67.0 min, P = 0.01) as compared with patients in whom this value was <10 g. Four groin haematomas were the only complications observed.
  
  
  CONCLUSIONS
  Contact force during RFCA for PV isolation affects procedural parameters, in particular procedural and fluoroscopy times, without increasing complications.
authors: Laboratorio di Elettrofisiologia, Clinica Mediterranea, 80122 Napoli, Italy.
authors: Giuseppe
authors: G
authors: Stabile
authors: Francesco
authors: F
authors: Solimene
authors: Leonardo
authors: L
authors: Calò
authors: Matteo
authors: M
authors: Anselmino
authors: Antonello
authors: A
authors: Castro
authors: Claudio
authors: C
authors: Pratola
authors: Paolo
authors: P
authors: Golia
authors: Nicola
authors: N
authors: Bottoni
authors: Giuseppe
authors: G
authors: Grandinetti
authors: Antonio
authors: A
authors: De Simone
authors: Roberto
authors: R
authors: De Ponti
authors: Serena
authors: S
authors: Dottori
authors: Emanuele
authors: E
authors: Bertaglia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005471:Fluoroscopy; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010865:Pilot Projects; D011667:Pulmonary Veins / Q000601:surgery*; D013314:Stress, Mechanical; D014110:Touch; D014159:Transducers; D016896:Treatment Outcome; D055815:Young Adult
keywords: Atrial fibrillation; Catheter ablation; Contact force