title: Randomized trial comparing pulmonary vein isolation using the SmartTouch catheter with or without real-time contact force data.
abstract: Contact force (CF) information may improve the safety and efficacy of ablation for paroxysmal atrial fibrillation (PAF).
  
  
  
  The purpose of this study was to assess the impact of CF data on ablation for PAF.
  
  
  
  Patients undergoing first-time PAF ablation were randomized at 7 UK centers to ablation with (CF-on) or without (CF-off) CF data available to the operator, using the same ablation catheter and mapping system. An ablation CF of 5-40g was targeted. Pulmonary vein (PV) reconnection was assessed with adenosine at 60 minutes. Follow-up for arrhythmia recurrence was for 1 year with 7-day Holter recordings at 6 and 12 months.
  
  
  
  One hundred seventeen patients were studied (59 CF-on, 58 CF-off). In the CF-on group, a reduction in acute PV reconnection rates (22% vs 32%, P = .03) but no significant difference in 1-year success rates off antiarrhythmic drugs (49% vs 52%, P = .9) was observed. There was no difference in major complication rates: 2 of 59 (3%) CF-on, 3 of 58 (5%) CF-off (P = .7). Procedural and fluoroscopy times were not significantly different (P>.5). Overall mean CFs per ablation were not different between groups (13.4 [9.1-19.6]g CF-on, 13.4 [7.4-22.4]g CF-off, P = .5), but a greater proportion of readings in the CF-on group were in the target range (80% vs 68%, P<.001).
  
  
  
  This randomized multicenter study demonstrated that CF data availability was associated with reduced acute PV reconnection but not improved 1-year success rates, procedural and fluoroscopy times, or complication rates. There was a reduction in extremes of CF, above and below the study target range, suggesting greater CF control during ablation.
authors.affiliation: Cardiology Research Department, Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom. Electronic address: waqas@doctors.org.uk.
authors.forename: Waqas
authors.initials: W
authors.lastname: Ullah
authors.affiliation: Cardiology Research Department, Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.
authors.forename: Ailsa
authors.initials: A
authors.lastname: McLean
authors.affiliation: Leeds General Infirmary, Leeds, United Kingdom.
authors.forename: Muzahir H
authors.initials: MH
authors.lastname: Tayebjee
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, United Kingdom.
authors.forename: Dhiraj
authors.initials: D
authors.lastname: Gupta
authors.affiliation: John Radcliffe Hospital, Oxford, United Kingdom.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Ginks
authors.affiliation: Plymouth Hospitals NHS Trust, Plymouth, United Kingdom.
authors.forename: Guy A
authors.initials: GA
authors.lastname: Haywood
authors.affiliation: Cardiovascular Division, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: O'Neill
authors.affiliation: The Heart Hospital, London, United Kingdom.
authors.forename: Pier D
authors.initials: PD
authors.lastname: Lambiase
authors.affiliation: Cardiology Research Department, Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Earley
authors.affiliation: Cardiology Research Department, Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Schilling
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011667:Pulmonary Veins / Q000601:surgery*
keywords: Atrial fibrillation; Catheter ablation; Contact force sensing; Randomized controlled trial