title: Real-time contact force sensing for pulmonary vein isolation in the setting of paroxysmal atrial fibrillation: procedural and 1-year results.
abstract: BACKGROUND
  The additional benefit of contact force (CF) technology during pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (AF) to improve mid-term clinical outcome is unclear.
  
  
  RESULTS
  Eligible patients with symptomatic paroxysmal AF were enrolled in this prospective trial, comparing circular antral catheter ablation (guided by Carto 3 System, Biosense Webster) using either a new open-irrigated CF catheter (SmartTouch Thermocool, Biosense Webster) (CF group) or a non-CF open-irrigated catheter (EZ Steer Thermocool, Biosense Webster) (control group). Overall, 30 patients were enrolled in each group, with a standardized 12-month follow-up, free of antiarrhythmic therapy. Demographic, cardiovascular and anatomic characteristics were similar in both groups. Though complete PVI was eventually achieved in all cases in both groups, success using an exclusive anatomic approach was 80.0% in CF group versus 36.7% in control group (P < 0.0001). CF use was associated with significant reductions in fluoroscopy exposure (P < 0.01) and radiofrequency time (P = 0.01). The incidence rates of AF recurrence were 10.5% (95% CI, 1.38-22.4) in the CF group, and 35.9% (95% CI, 12.4-59.4) in the control group (log rank test, P = 0.04). After adjustment on potential confounders, the use of CF catheter was found to be associated with a lower AF recurrence (OR 0.18, 95% CI 0.04-0.94, P = 0.04).
  
  
  CONCLUSIONS
  Our findings suggest a potential benefit of real-time CF sensing technology, in reducing AF recurrence during the first year after PVI.
authors.affiliation: Clinique Pasteur, Département de Rythmologie, Toulouse, France; Paris Cardiovascular Research Center, Paris, France.
authors.forename: Eloi
authors.initials: E
authors.lastname: Marijon
authors.forename: Samia
authors.initials: S
authors.lastname: Fazaa
authors.forename: Kumar
authors.initials: K
authors.lastname: Narayanan
authors.forename: Benoit
authors.initials: B
authors.lastname: Guy-Moyat
authors.forename: Abdeslam
authors.initials: A
authors.lastname: Bouzeman
authors.forename: Rui
authors.initials: R
authors.lastname: Providencia
authors.forename: Frederic
authors.initials: F
authors.lastname: Treguer
authors.forename: Nicolas
authors.initials: N
authors.lastname: Combes
authors.forename: Agustin
authors.initials: A
authors.lastname: Bortone
authors.forename: Serge
authors.initials: S
authors.lastname: Boveda
authors.forename: Stephane
authors.initials: S
authors.lastname: Combes
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Albenque
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D003199:Computer Systems; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D013314:Stress, Mechanical; D013499:Surface Properties; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D016896:Treatment Outcome
keywords: atrial fibrillation; catheter ablation; contact force; pulmonary vein isolation; radiofrequency ablation