title: Higher contact-force values associated with better mid-term outcome of paroxysmal atrial fibrillation ablation using the SmartTouch™ catheter.
abstract: OBJECTIVE
  Real-time measurement of contact force (CF) during catheter ablation of atrial fibrillation (AF) has been recently suggested to potentially impact procedural outcome. However, the role of CF intensity on mid-term results using the SmartTouch™ catheter has not been investigated so far.
  
  
  RESULTS
  Pulmonary vein isolation (PVI) using the SmartTouch™ catheter was performed in 100 eligible patients (age 62 ± 8; 79% men) undergoing a first procedure of paroxysmal AF catheter ablation. Continuous CF monitoring during catheter ablation allowed calculation of mean CF per patient. Patients were dichotomized into high CF (≥22 g, upper quartile) and low CF (<22 g, remaining) and enroled in a standardized follow-up programme (after a 3-month blanking period), free from antiarrhythmic therapy, with regular evaluations including 24 h Holter recordings at 1, 3, 6, 9, 12, 18, and 24 months. Atrial fibrillation relapse was defined as any symptomatic or asymptomatic atrial arrhythmia lasting >30 s. The average CF among all procedures was 19.6 ± 3.7 g. Though complete PVI was eventually achieved in all cases in both groups, success using an exclusively anatomical approach was higher in the high CF group (92.0 vs. 72.0%; P = 0.04). During a mean follow-up of 19 ± 5 months, a lower incidence of AF relapse was observed in higher CF patients (4.0 vs. 20.0%; log rank P = 0.04). Pericardial tamponade occurred in one patient in the higher CF group. No thromboembolism or procedure-associated deaths were observed.
  
  
  CONCLUSIONS
  Higher values of CF overall during antral PVI appear to be associated with a higher likelihood of sinus rhythm maintenance without significantly increasing the complication rate.
authors.affiliation: Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France rui_providencia@yahoo.com.
authors.forename: Rui
authors.initials: R
authors.lastname: Providência
authors.affiliation: European Georges Pompidou Hospital, Paris, France.
authors.forename: Eloi
authors.initials: E
authors.lastname: Marijon
authors.affiliation: Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Combes
authors.affiliation: Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.
authors.forename: Abdeslam
authors.initials: A
authors.lastname: Bouzeman
authors.affiliation: Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.
authors.forename: François
authors.initials: F
authors.lastname: Jourda
authors.affiliation: Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Khoueiry
authors.affiliation: Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Cardin
authors.affiliation: Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Combes
authors.affiliation: Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Boveda
authors.affiliation: Département de Rythmologie, Clinique Pasteur, 45 Avenue de Lombez, BP 27617, 31076 Toulouse Cedex 3, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Albenque
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D018780:Body Surface Potential Mapping / Q000295:instrumentation*; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013314:Stress, Mechanical; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000295:instrumentation*; D014110:Touch; D016896:Treatment Outcome; D014584:User-Computer Interface
keywords: Arrhythmia; Catheter ablation; Contact-assisted ablation; Outcomes