title: Incidence and anatomical locations of catheter instability during circumferential pulmonary vein isolation using contact force.
abstract: In addition to contact force (CF), catheter stability is considered to be an important factor in creating radiofrequency lesions.To evaluate the catheter stability during pulmonary vein isolation (PVI) using CF-sensing catheter.PVI was performed in 32 patients using a CF-sensing catheter. Operators were blinded to CF. The application was arbitrarily defined as a "visually unstable" point if the catheter moved ≥ 4 mm. Data were analyzed according to 6 predefined segments for the ipsilateral PVs. As a parameter of catheter stability, the standard deviation (SD) of CF and relative standard deviation (RSD = 100 × SD of CF /average CF) were introduced.A total of 932 RF applications with 426 visually unstable points (UP; 45.7%) and 506 stable points (SP; 54.3%) were analyzed. SD was significantly higher at UP (8.0 g versus 5.7 g, P < 0.001), and RSD was significantly higher at UP (43.7% versus 26.5%, P < 0.001). Higher RSD was associated with visual instability in all the segments of both PVs, however, higher SD of CF was not in all segments. At the antero-superior segment of the LPV, and the roof and posteroinferior segments of the RPV, the RSD values were over 50%, suggesting catheter instability.Catheter instability occurred in 45% of ablations during PVI and was predominantly located in the antero-superior segment of the LPV and postero-inferior segment of the RPV, which may result in incomplete lesion formation. RSD had significant correlation with visual catheter stability.
authors.affiliation: Department of Cardiology, Asklepios Klinik St. Georg.
authors.forename: Hisaki
authors.initials: H
authors.lastname: Makimoto
authors.forename: Roland Richard
authors.initials: RR
authors.lastname: Tilz
authors.forename: Tina
authors.initials: T
authors.lastname: Lin
authors.forename: Andreas
authors.initials: A
authors.lastname: Rillig
authors.forename: Shibu
authors.initials: S
authors.lastname: Mathew
authors.forename: Sebastian
authors.initials: S
authors.lastname: Deiss
authors.forename: Erik
authors.initials: E
authors.lastname: Wissner
authors.forename: Andreas
authors.initials: A
authors.lastname: Metzner
authors.forename: Peter
authors.initials: P
authors.lastname: Rausch
authors.forename: Alexander
authors.initials: A
authors.lastname: Bardyszewski
authors.forename: Qingyong
authors.initials: Q
authors.lastname: Zhang
authors.forename: Masashi
authors.initials: M
authors.lastname: Kamioka
authors.forename: Christine
authors.initials: C
authors.lastname: Leme
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.forename: Feifan
authors.initials: F
authors.lastname: Ouyang
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery*; D062906:Cardiac Catheters / Q000009:adverse effects*; D017115:Catheter Ablation / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005858:Germany / Q000453:epidemiology; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins