title: The importance of catheter stability evaluated by Visitag(TM) during pulmonary vein isolation.
abstract: BACKGROUND
  The recurrence rates of atrial fibrillation (Af) after ablation are still high, and repeat procedures are required in these patients. The main reason for Af recurrence is the recovery of the conduction between the pulmonary veins and left atrium. The importance of catheter stability during the pulmonary vein isolation (PVI) is not well studied.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the contact force (CF), stable ablation time, and power during conduction blocking lesion formation for PVI.
  
  
  METHODS
  Thirty-two consecutive drug-refractory Af patients who underwent an initial PVI using CARTO 3 and Visitag were included. The CF, ablation time, force time integral (FTI), and ablation power were recorded by Visitag. Residual conduction gap points requiring touch-up ablation after an encircling linear ablation (R point), spontaneous reconnection points (S point), and dormant conduction points (D point) were considered as non-conduction blocking lesion points. Each ablation parameter for the non-conduction blocking lesion points was compared with the other lesion points.
  
  
  RESULTS
  Twenty-one points in 16 patients were considered non-conduction blocking lesions. Ten were R, eight were S, and three were D points. The CF, ablation time, FTI, and power at the non-conduction blocking lesion points and other points were 12.0 g (7.0-21.5) and 12.0 g (9.0-16.0) (P = 0.9), 7.7 s (5.6-10.1) and 12.5 s (9.4-16.8) (P < 0.05), 103.0 g*s (62.0-174.5) and 149.0 g*s (104.0-213.0) (P < 0.05), and 30.0 W (22.5-30.0) and 30.0 W (30.0-30.0) (P = 0.06), respectively.
  
  
  CONCLUSIONS
  Shorter ablation time recorded in Visitag lead to non-conduction blocking lesion.
authors.affiliation: Department of Cardiology, Saiseikai Nakatsu Hospital, Shibata 2-10-39, Kita-ku, Osaka-shi, Osaka, 530-0012, Japan. snowreveries119@yahoo.co.jp.
authors.forename: Ryudo
authors.initials: R
authors.lastname: Fujiwara
authors.affiliation: Department of Cardiology, Saiseikai Nakatsu Hospital, Shibata 2-10-39, Kita-ku, Osaka-shi, Osaka, 530-0012, Japan.
authors.forename: Kimitake
authors.initials: K
authors.lastname: Imamura
authors.affiliation: Department of Cardiology, Saiseikai Nakatsu Hospital, Shibata 2-10-39, Kita-ku, Osaka-shi, Osaka, 530-0012, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kijima
authors.affiliation: Department of Cardiology, Saiseikai Nakatsu Hospital, Shibata 2-10-39, Kita-ku, Osaka-shi, Osaka, 530-0012, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Masano
authors.affiliation: Department of Cardiology, Saiseikai Nakatsu Hospital, Shibata 2-10-39, Kita-ku, Osaka-shi, Osaka, 530-0012, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Nagoshi
authors.affiliation: Department of Cardiology, Saiseikai Nakatsu Hospital, Shibata 2-10-39, Kita-ku, Osaka-shi, Osaka, 530-0012, Japan.
authors.forename: Amane
authors.initials: A
authors.lastname: Kohzuki
authors.affiliation: Department of Cardiology, Saiseikai Nakatsu Hospital, Shibata 2-10-39, Kita-ku, Osaka-shi, Osaka, 530-0012, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shibata
authors.affiliation: Department of Cardiology, Saiseikai Nakatsu Hospital, Shibata 2-10-39, Kita-ku, Osaka-shi, Osaka, 530-0012, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Tsukiyama
authors.affiliation: Department of Cardiology, Saiseikai Nakatsu Hospital, Shibata 2-10-39, Kita-ku, Osaka-shi, Osaka, 530-0012, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Takeshige
authors.affiliation: Department of Cardiology, Saiseikai Nakatsu Hospital, Shibata 2-10-39, Kita-ku, Osaka-shi, Osaka, 530-0012, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Yanaka
authors.affiliation: Department of Cardiology, Saiseikai Nakatsu Hospital, Shibata 2-10-39, Kita-ku, Osaka-shi, Osaka, 530-0012, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nakano
authors.affiliation: Department of Cardiology, Saiseikai Nakatsu Hospital, Shibata 2-10-39, Kita-ku, Osaka-shi, Osaka, 530-0012, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Fukuyama
authors.affiliation: Department of Cardiology, Saiseikai Nakatsu Hospital, Shibata 2-10-39, Kita-ku, Osaka-shi, Osaka, 530-0012, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Shite
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D018780:Body Surface Potential Mapping; D017115:Catheter Ablation / Q000295:instrumentation*; D005260:Female; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008297:Male; D009038:Motion; D011667:Pulmonary Veins / Q000601:surgery*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012984:Software; D013314:Stress, Mechanical; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
keywords: Ablation; Atrial fibrillation; Catheter stability; Contact force; Pulmonary vein isolation